O C

ORGANIZING COMMITTEE
Chief Patron
H.H. Swami Poornamritananda Puri
Patrons
Dr. Venkat Rangan, Vice Chancellor, Amrita Vishwa Vidyapeetham
Dr. Prem Nair, Medical Director, Amrita Institute of Medical Sciences
Dr. Prathapan Nair, Principal, Amrita School of Medicine
Organizing Secretary
Prof. D. M. Vasudevan
Joint Organizing Secretary
Dr. Subir Kumar Das
Dr. Kannan Vaidyanathan
Executive Committee Members
Dr. Subhakumari K.N (Chairperson)
Dr. T.Vijayakumar
Dr. Subramanya Iyer
Dr. R.Krishna Prasad
Dr. Deepthi Menon
Chairpersons of Committees
Scientific Committee : Dr. S. Sreekumari
CME : Dr. V. Balakrishnan
Workshop : Dr. Krishnakumar Menon
Treasurer : Dr. P.N.K Menon
Cultural : Dr. Jagath Lal
Reception, Hospitality and Food:
Dr. Sajitha Krishnan, Dr. P. Sujaya, Dr. Leela Menon
Exhibition : Dr. Indira Samal
Corporate Liaison:Dr. Ramesh Kumar, Mr. M.V Thampi
Accommodation and Transport: Dr. (Mrs) P.G Nair
ACBICON 2009 LOCAL ADVISORY BOARD
Dr. Asuma Beevi, Dr. Beena.C, Dr. Geeta.A, Dr. Geetha.A, Dr. Geetha Damodaran, Dr. George Abraham,
Dr. Gopinathan Nair.S, Dr Jaya.S, Dr. Jayanthi Bai, Dr. Jeeji Palokaren, Dr. Jose Jacob, Dr. Jose Raj,
Dr. Minnie Mary Mammen, Dr. Miriam Varkey, Dr. Mohanan, Dr. Parvathy, Dr. D. Prasanna, Dr. C.S
Poulose, Dr. Pushpalatha, Dr. Rajasekharan Pillai, Dr. K.Ramachandran, Dr. Sajeevan, Dr. Sankar
Saidharan, Dr. Sathyasudha, Dr. N.Sreedevi, Dr. S.Sreekumari, Dr. Sreekumar, Dr. P.R Sudhakaran,
Dr. B.Sulekha, Dr. Sundara Devi, Dr. T.Vijayakumar, Dr. Vijayalekshmi
ACBICON 2009 NATIONAL ADVISORY BOARD
Dr T. Ashavaid, Prof. S.P Dandekar, Dr. T.P.A Devasagayam, Prof. Dinesh Puri, Dr U.N Donde, Prof
B.C Harinath, Prof. A.S Kanagasabapathy, Prof. Krishnajyoti Goswami, Prof. M.V. Kodliwadmath,
Prof. P.C Mahapatra, Prof. Abbas Ali Mahdi, Prof. T. Malati, Prof. K.L Mukherjee, Prof. P.S Murthy,
Prof. N.C Panda, Prof. T.N. Pattabhiraman, Prof. Praveen Sharma, Prof. D.N. Rao, Prof. Sandip
Bandopadhyay, Prof. U. Satyanarayana, Dr. R. Selvakumar, Prof. P.P. Singh, Prof. K.P. Sinha, Brig.
(Dr) Y.V. Sharma, Prof. P.S. Shukla, Prof. K.K. Srivastava, Prof. L.N. Srivastava, Prof. Subrata
Chattopadhyay, Prof. Subrata Sinha, Prof. B.N. Tiwari, Prof. Uday Kumar, Prof. P. Usha Sarma, Prof.
T. Venkatesh, Prof. H.S. Virupaksha.
All founder members, All Past presidents and members of various committees of national body.
ACBICON 2009 INTERNATIONAL ADVISORY BOARD
Prof. Amitava Dasgupta, Dr. Beremans Lopez, Dr. Elizabeth Frank, Dr S Jamal Raja, Prof. Liaquat
Ali, Dr. Lindsay Brown, Dr. Michel Silvestri Joseph, Prof. Dr. Md. Suhrab Ali, Dr V Parameswaran,
Dr. Perry Gotlesfeld, Dr. Samuel Vasikaran, Dr. Tom Hartley, Dr Udayan Ray
CONTENTS
ORATIONS
O-1. : Dr. T.N Pattabhiraman Oration
Laboratory Overload: How to Optimize?
Brig. M.M. Arora
46
O-2. : K.E.M. Hospital and Seth G.S. Medical College Oration
Regenerative Nanomedicine - Prospects for Diagnostics and
Therapy using Nanomaterials
Shanti Kumar Nair
46
O-3.: Mrs. & Dr. G.P Talwar Oration
Endothelial Dysfunction with Special Reference to eNOS Gene
Polymorphism: Another Plausible Mechanism for CAD Risk in
Postmenopausal Women
Jayashree Bhattacharjee
47
O-4. : K.L Gupta Memorial Oration
Tyrosine Kinases from Basic Science to Therapy
T.S.Ganesan
48
O-5- :Awadesh Saran Memorial Oration
Lead Poisoning: Current Status in Developing Countries and the
Global Perspective.
Thuppil Venkatesh
48
KEY NOTE ADDRESSES
KN-1. Vitamin E is activated by phosphorylation to alphatocopheryl phosphate
Angelo Azzi
50
KN-2. Impact of Pharmacogenetics on Therapeutic Drug
Monitoring
M. Oellerich, V.W. Armstrong and N. von Ahsen
51
INVITED LECTURES
IL-1.:The role of Bone Turnover Markers in Clinical Management
of Osteoporosis
SD Vasikaran
52
IL-2. : A New Diagnostic Paradigm: Some Enabling Technologies
Ross Barnard
52
IL-3: The Natural Phenolic, Malabaricone B Selectively Kills the
Cancer Cells through Mitochondrial Pathway
S. Chattopadhyay
53
CONTENTS
IL-4: Marine Brown Algae with Potent Antioxidant and Radical
Scavenging Activities
M.S.Kanthimathi, Ghaitri Nadarajan and Khoo Kong Soo
53
IL-5: Male Infertility: Role of Oxidative Stress and Some Possible
Herbal Remedies
Abbas Ali Mahdi, Mohd. Kaleem Ahmad, Kamla Kant Shukla,
Singh Rajender, Satya Narain Shakhwar and Sohail Ahmad***
54
IL-6: [(E)-HST-1], 3’ -5’ Hydroxylated Congener of Resveratrol,
A Better Anticancer Agent
Sandip K Bandyopadhyay
55
IL-7: Oxidative Stress Management: Therapeutic Approach for
Depression
Naheed Banu, Ayesha Zafir, Shoa Naqvi and Ghazala Mehdi
56
IL-8: Antioxidant Potential and LDL Oxidation in Disease.
Dr. Neelima Singh and Nivedita Singh.
56
IL-9: Total Quality Management in Health Laboratories
Dr. Ghassan Shannan
57
IL-10: Beyond Means and SDS: Recommended Statistics for
Knowledge Extraction from Accumulated Pathology Data and Your
Practice Experience
T F Hartley
57
IL-11: Web Based Education and Training in Clinical Laboratory
Services
Dr. Uday Donde
59
IL-12: Lean - Sigma Metrics Protocol of Total Quality Management
in a New Laboratory Set-up
Barnali Das*
59
IL-13: Laboratory Management of the Metabolic Syndrome
Sridevi Devaraj
60
IL-14: Thyrotropin Secreting Pituitary Adenomas (TSHoma)
V.Parameswaran, G.Stilwell and J.Burgess
61
IL-15: Monogenic Disease in Endocrinology
Tjin-Shing Jap
62
IL-16: Obesity – A Global Epidemic
Dr.Nalini Ganesan
62
IL-17: Novel Interactive Signal Molecules in the Hypothalamus
Regulating GNRH Release
Dr. Edathil Vijayan
63
CONTENTS
IL-18: Role of Ethanol in Inducing Inflammatory Brain Damage
and Vasculogenesis
Sukhes Mukherjee, Subir Kumar Das, Subrata Chattopadhyay and
D.M Vasudevan
64
IL-19: Culture of Rat Gastric Mucosal Cell Line RGM1 or its
Tumor Cell Line RGK1 Combined with Human Fibroblasts
Hideyuki J Majima, Yoko Yamaguchi, Mitsuhiro Ohshima, Hiroko
P Indo, Kazuo Tomita, Yoichiro Iwashita, Hsiu-Chuan Yen, Takuro
Kodama, Masakazu Souda, Akihide Tanimoto, Motoharu
Miymoto, Kazuyuki Noguchi, Osamu Shimokawa Yumiko
Nagano, Tsuyoshi Kaneko, Hirofumi Matsui, and Toshihiko Ozawa
64
IL-20: Cancer Biomarkers of Prognostic Value
Paturu Kondaiah
65
IL-21: HPV 16 Variants in Normal, SIL and Cervical Cancer
Women.
Neeta Singh, Chandresh Sharma, Archna Singh Palika Datta and
Sunesh K. Jain
65
IL-22: An Update in Molecular Oncology: Cervical Cancer
B.Nagarajan
66
IL-23: Natural Products as Potential Treatments for the Human
Metabolic Syndrome
Lindsay Brown
67
IL-24: Association of Cytokines and Insulin Resistance in NonAlcoholic Fatty Liver Disease
Subir Kumar Das
67
IL-25: The Promise of Stem Cells and Gene Therapy as Novel
Approaches to the Treatment of Multiple Sclerosis (MS)
Natalie Payne, Christopher Siatskas, Guizhi Sun, Daniella
Herszfeld, Natalie Seach, Sara Litwak, Martin Short, Ban-Hock
Toh, Frank Alderuccio, Thomas Backstrom, Richard L Boyd, and
Claude C A Bernard
68
IL-26: Hs-CRP, Inflammation and Its Role in Coronary Heart
Disease
Arun Raizada, H V Singh and Naresh Trehan
70
IL-27: Pro-oxidant Activity of Artemisinin Causes an Apoptosis
Like Death in Leishmania parasites
Mitali Chatterjee and Rupashree Sen
70
IL-28: Novel Filarial Genes or Recombinant Filarial Proteins as
Effective Vaccine Candidates
MVR Reddy
71
CONTENTS
IL-29: Bilirubin from Toxic Metabolite to an Antioxidant:
Mechanisms
S. Adhikari
72
IL-30: New Perspectives on the Clinical Importance and
Applications of Vitamin D Testing
H.A Morri
72
IL-31: An Insight to the Mechanism of Lycopene: A Biocarotenoids
Against ã-Radiation Induced Apoptosis; MAPK Signaling
Pathways and DNA Repair Enzymes in Normal Lymphocytes and
Lymphoblastoid TK-6 Cell Lines in Vitro.
Venugopal P. Menon
73
IL-32:The Role of CRP in Atherothrombosis
Ishwarlal Jialal
73
IL-33: The Clinically Effective Use of Available Cardiac
Biomarkers.
Ray U
74
IL-34: Mycobacterial ES-31 Serine Protease of Interest in
Diagnosis of Tuberculosis and HIV-TB Co-infection and with
Potential as Drug Target
B.C. Harinath
75
IL-35: Autoantibodies: Is it Possible to Predict Autoimmune
Diseases?
Marcos López-Hoyos
76
IL-36: Cell-Cycle Synchronization in Antinuclear Antibodies
Detection
Petraki Munujos Vinyoles
76
IL-37: Importance of Monitoring Magnesium Levels in Cardiac
Conditions
Dr. S. P. Dandekar
77
IL-38: Tissue Zinc Levels in Carcinoma
Dr. R. Selvakumar
77
IL-39: Prenatal Screening for Chromosomal Disorders
Päivi Laitinen
78
IL-40: Routine Screening of Newborns for Metabolic Disorders
using Tandem Mass Spectrometry
Rohit Cariappa
79
IL-41: Diagnosis of Aminoacidurias by HPLC: A Few Interesting
Cases
Dr. Kannan Vaidyanathan
80
CONTENTS
IL-42: Specific Plant-Derived Products with Relevance to Clinical
Medicine
PG Latha
80
IL-43: Natural Products and Therapeutic Strategies: A Mechanistic
Approach
Bipin Nair
81
IL-44: ABC of Monoclonal Gammapathy and its Indian Scenario
T.Malati
81
IL-45: The Clinical Significance of Microalbuminuria
T.Malati
82
IL-46: Biochemical Changes in Mountain Sickness
Savitha Nagabhushan, Thuppil Venkatesh, Vidyasagar Casikar
E Mujica , J. Aliaga , N.Lopez , C.Smith , F. Bartholomew and
Gustavo Zubieta-Calleja (Jr), Gustavo Zubieta-Castillo (Sr), and
Poul-Erik Paulev
M.Mongelli
83
IL-47: The High Altitude Adaptation Formula
GR Zubieta-Calleja, P.E. Paulev, L Zubieta-Calleja & G.ZubietaCastillo
83
IL-48: Do Over 200 Million Healthy Altitude Residents Really
Suffer from Chronic Acid- Base Disorders?
Gustavo Zubieta-Calleja (Jr), Gustavo Zubieta-Castillo (Sr), and
Poul-Erik Paulev, High Altitude Pathology Institute, La Paz,
Bolivia. [email protected]
84
IL-49: The Ventilatory Hyperoxic Shunt Test at 3510 m. of
altitudeG Zubieta-Castillo, L. Zubieta-Calleja, and GR ZubietaCalleja,
85
IL-50: Get Together on Biochemistry - An Experimental Teaching
Dr.W.Ebenezer William
85
IL-51: The Role of Clinical Chemist in the Management of PatientRay U
86
IL-52: Maturity Onset Diabetes in the Young (MODY)
V.Parameswaran, A.Duffield, S.Powell, J.Burgess
86
IL-53: Post -transplant Diabetes Mellitus Following
Immunosuppressive Therapy
Dr. Pragna Rao
87
IL-54: Point-of- Care testing (POCT)
C.V.Anand
88
CONTENTS
IL-55: Protein Misfolding Diseases
Dr.Usha Anand
88
IL-56: Obesity – A Global Dilemma
V.Parameswaran, L.Blackwell, L.Diggle, J.Burgess and
R.McCallum
89
IL-57: Scholarly Communication: Writing a Research Paper for a
Peer-Reviewed Publication
R S Jayasomu
90
IL-58: Urine Albumin: Standardisation and Reporting Issues.
H. D. Martin
90
IL-59: Molecular Mechanisms of Angiogenesis in Heart and Lung
Hari S. Sharma
91
IL-60: The Pro-Inflammatory Role of Extracellular RNA in
Arteriogenesis
Elisabeth Deindl
92
IL-61: Pharmacogenomics: One Size Does Not Fit All
Dr. Amit Chakrabarti.
93
IL-62: Lead Not Safe in Environment
Dr. Krishnajyoti Goswami
93
IL-63: Developments in the Biochemical Assessment of Renal
Disease
David Torrens
94
IL-64: ISO 15189 : 2007
Dr. Elizabeth A. Frank
95
ABSTRACTS OF PRESENTATIONS
Abstract No: 1.1: A Study on Free and Total Prostate Specific
Antigen in Benign Prostatic Hyperplasia (BPH) and Carcinoma
Prostate
Dr.R. Lalitha
96
Abstract No: 1.2: Evaluation of Enzyme Markers in Carcinoma
Cervix.
Dr.P.B.Desai and Dr.Chetana.K
96
Abstract No: 1.3: Serum Fluoride and Sialic Acid Levels in
Osteosarcoma
R. Sandhu, Z. S. Kundu, S. Kharb and Harbans Lal
97
Abstract No: 1.4: Diagnosis of Breast Cancer by the Determination
of Plasma Maspin Level
Karabi Ganguly (Bhattacharjee), G.V.Girish and Asru K. Sinha
98
CONTENTS
Abstract No: 1.5: Evaluation of Serum Tumor Markers and Fertility
Hormones in Postmenopausal Women with Ovarian Cancer
L. Vishnu Prasad and Dr.R.Arivazagan
98
Abstract No: 1.6: Serum sialic acid forms as tumors head, neck,
thyroid & lung tumors.
Mahendra R. Pakhale , Dr.Murhar and Rajesh Rajrkar
99
Abstract No: 1.7: Matrix Metalloproteinases and Their Inhibitors:
Correlation with Invasion and Metastasis in Oral Squamous Cell
Carcinoma
Ragini D. Singh, N Haridas, Shilin N. Shukla, Jayendra B.Patel,
Bhairavi N. Vajaria and Prabhudas S. Patel
100
Abstract No: 1.8: A Study of Oxidative Stress in Cancer Patient
before and after Supplementation of Vitamin C and E
Dr. Pranami Bordoloi, Dr. Bikash Kr. Chaudhury, Dr. Chandan
Kr. Nath and Dr. Dipali Das
101
Abstract No: 1.9: Role of Serum Enzymes in Oral Cancer.
Dr P.B Desai and Dr Shikha Sharma
101
Abstract No: 1.10: Biochemical and Hematological Markers in
Patients with Chromosome 22q11.2 Deletion and Conotruncal
Defects.
Alka Anilkumar, M.V.Thampi, R.Krishna Kumar, K.Mahesh,
Sheela Nampoothiri, Sindu T.K, and D. M. Vasudevan.
102
Abstract No: 1.11: Enhanced 5HT2A Receptors in the Cerebral
Cortex of Hypoxia Induced Neonatal Rats: Effect of Glucose and
Oxygen Supplementation
Anju T. R, Pretty Mary Abhraham and C. S. Paulose
103
Abstract No: 1.12: Diagnosis of Organic Acidurias in Children - 2
Years Experience in a Tertiary Care Center
M P Narayanan, Kannan Vaidyanathan and D M Vasudevan
104
Abstract No: 1.13: Detection of Inborn Errors of Metabolism in
Paediatric Age Group in a Tertiary Care Centre.
Saritha KamathU, Licy C.D, Nalini Bhaskaranand, and Anjali Rao
104
Abstract No: 1.14: Hyperprolinemia in 22q.11 Deletion Syndromes
and its Association with Neurological Deficits
Sweetha Mary Mammen, Dr. K.N. Subhakumari and M. V. Thampi
105
Abstract No: 1.15: Hypoglycaemia
Biswajit Saha
105
Abstract No: 1.16: Dyslipidemias
Prof. N. Haridas
106
Abstract No: 1.17: Effect of Swimming on Selected Health
Parameters of Beginners
Ragini Srivastava, Royana Singh, Ratna Pandey and Amit
Srivastava
106
CONTENTS
Abstract No: 1.18: Evidence-Based Guidelines for the use of
Biochemical Markers of Bone Turnover in the selection and
monitoring of Bisphosphonate Treatment in Osteoporosis: A
Consensus Document of the Belgian Bone Club
Dr.Maulik Nayak, Dr. Alok Parekh, Dr.Rita Shah and Dr. D.A.
Trivedi
107
Abstract No: 1.19: Requirement of Essential Fatty Acids: An
Analytical Approach
Dr. Sankar Roy
108
Abstract No: 1.20: Clinical Approach to Integrated Basic Sciences
Teaching
Shruti Mohanty
108
Abstract No: 1.21: A Study on Organic Aciduria: Detection and
Quantification using HPLC
Aswathi K.I, Narayanan MP and Kannan Vaidyanathan
109
Abstract No: 1.22: ELISA based Evaluation of 17-á Hydroxy
Progesterone as a Diagnostic Marker for Congenital Adrenal
Hyperplasia and Assessment of Hyperhomocysteinemia in
Coronary Artery Diseases and Cerebrovascular Accidents
Jayakumar N., Dr. Sujaya P and Dr. Kannan Vaidyanathan
109
Abstract No: 1.23: Standardisation of Chromatographic
Techniques: HPLC & GC – A Diagnostic Tool for Inborn Errors
of Metabolism
Ms. Amalmol Peter and Dr. Kannan Vaidyanathan
110
Abstract No: 1.24: Faecal Calprotectin in Inflammatory Bowel
Diseases
M.P. Narayanan, Kannan Vaidyanathan, O. Gajendra, S. Shine and
V. Balakrishnan
111
Abstract No: 1.25: A Study on Cytotoxicity and Inhibition of
Cyclooxygenase-2 by Curcumin and Diallyl Sulfide in Head And
Neck Cancer Cell Line
Hariharasudan. R
112
Abstract No: 1.26: A Study for Investigating the Association
between Semen Biochemical Parameters and Routine Clinical
Semen Parameters in Infertile Men
Suresh S. and T. Vijayakumar
112
Abstract No: 1.27: Isolation and Validation of the Biomarker
MMP1 from Salivary Transcriptome for Early Detection of Oral
Cancer
Kannappan Alagappan, Amritha Suresh and M A Kuriakose
113
Abstract No: 2.1: Serum Copper and Magnesium Level in Type –
2 Diabetes Mellitus
B.K.Agrawal, Seema Tamrakar and V.K.Sharma
114
CONTENTS
Abstract No: 2.2: Biochemical Profile of Cord Blood in Normal
Pregnancy and Pregnancy Induced Hypertension
Miss D.Prathima , Dr. U.B.Vijaya lakshmi and Prof. Dr. K. Ambika Devi
115
Abstract No.2.3: Relationship between Micronutrient Intake of
Mothers and Metabolic Outcomes in Offspring (6 and 12 yrs):
Pune Maternal Nutrition Study
S.S.Naik, D.S.Bhat, C. Joglekar and C.S.Yajnik
115
Abstract No: 2.4: Lack of Awareness Resulting in Lead Poisoning
in Unorganized Sector of Battery Workers
Dr. Vishal Babu G N, Mr. Raviraja A and Dr. T Venkatesh
116
Abstract No: 2.5: Estimation of Zn, Mg in Several Protein Energy
Malnutrition in Children Age Group 6 Month to 5 Year
Farha Ali, B. K. Agrawal and Manjusa Goel
117
Abstract No: 2.6: Zn and Fe Levels in Hypothyroid Subjects: A
Hospital Based Case Control Study.
Gaurav B. Shetty, Suchetha Kumari.N and Smitha.P
117
Abstract No: 2.7: Extracellular Mg2+ Decreases Loading of the
Ca2+-Sensitive Fluorescent Probe Chlortetracycline, into Calcium
Stores in Lymphocytes and Neutrophils
Nivedita L. Rao and Jose Jacob
118
Abstract No: 2.8: Expression of Metallothionein (MT) in Colonic
Precancerous and Cancerous Tissue in Animal Model
Pamela Christudoss, and R. Selvakumar
118
Abstract No: 2.9: A Study of Serum Ferritin Levels among Male
Blood Donors
Ramesh Kumar and Dr.Shanmugam
119
Abstract No: 2.10: Study of Serum Magnesium Levels in Diabetic
Nephropahty
M. Ravi kanth, Dr. A.K. Bansal and Mrs. Lincy Jacob
120
Abstract No: 2.11: Effect of Aluminum on Cardiac Rhythm of Male
Albino Rats: An Electrocardiogram Study
Sadhana Verma, Pradeep Kumar, M. Y. Khan, Sandeep Tripathi
and A. A. Mahdi
121
Abstract No: 2.12: Serum Calcium, Phosphorus and Alkaline
Phosphatase Levels in Preterm Babies
Sarika Singh Chauhan, B. K. Agrawal and Rashmi Dwivedi
121
Abstract No: 2.13: Hypomagneseamia in Diabetes Mellitus
Shymala Manga, Dr.B.Prabhakar Rao and Dr.Sunanda
122
CONTENTS
Abstract No: 2.14: Study of Biochemical Markers in Iron
Deficiency Anemi
Smita B. Pawar
122
Abstract No: 2.15: Estimation of Toxic Lead (Pb) Contamination
of Tapioca (Manihot esculenta) in Kerala State
Subin Joy, Shaikh Mohammed and V.V Pillay
123
Abstract No: 2.16: The effect of Vitamin E Supplementation on
Soluble P-Selectin Levels in Pre-Eclampsia
Sujata Wangkheimayum, Sunil Kumar and Vanita Suri
123
Abstract No: 2.17: 5 – Methyl Tetrahydrofolate in Dried Blood
Spot as an Indicator of Folate Status in Humans
Thippeswamy. T.G, Ravinder Punjal and Madhavan Nair.K
124
Abstract No: 2.18: Age Related changes in Clcium, Phosphorous
and Calcitonin in Healthy Women with special reference to
Premenopausal and Post menopausal Women
Miss V. Meenakshi, Dr.S.K. Sen and Dr. Roma Rattan
125
Abstract No: 2.19: Effects of Resveratrol on Expression of Critical
Bone Remodelling Factors in Surgical Menopause Model of Rat
Alka Khera, Dr. Thungapathra M, Dr. Jaswinder Kalra and Dr.
Sujata Ghosh
125
Abstract No: 2.20: An Experimental Evaluation of Cytoprotective
Effect of Amifostine on CHOP Chemotherapy in Albino Rats
Ambili Remesh
126
Abstract No.2.21: Biochemical Changes in Acute
Organophosphorus Poisoning
Indira A Hundekari, A.N.Suryakar, Nilima N. Dongre, J G
Ambekar, B.B.Devaranavadagi and D.B.Rathi.
127
Abstract No: 2.22: Lead Toxicity Among Automobile Workers
Nilima N. Dongre, A.N.Suryakar, A.J.Patil,I.A.Hundekari,
J.A.Patil,J.G.Ambekar B.B.Devaranavadgi, D.B.Rathi and Rama
Jailkhani
127
Abstract No: 2.23: Tacrolimus in Renal Transplant Recipients
Dr.Pradeep Naik and Mallikarjuna .M
128
Abstract No: 2.24: Biochemical Effects of Feeding Soft Drink
and Ethanol
Arun Raj, Praveen Kottath Veetil, Sheeba Varghese, J K Mukkadan
and P K Joseph
129
CONTENTS
Abstract No: 2.25: Comparative Study for Slow Acetylator Status
by Phenotype / Genotype Polymorphism of N-acetyltransferase-2
in Patients on Antitubercular Treatment
S.V.Rana, Sanjeev K.Sharma, R. P. Ola, S.Arora, S.K.Sinha, P
Pandhi and K.Singh
129
Abstract No: 2.26: Correlation of Gall Stone Disease with IronDeficiency Anemia
Prakash A; Lal A.K; Sachan P.K and Sahu S.K.
130
Abstract No: 2.27: Trace Elements in Leprosy
Dr V B Londhe, Sevarina Madhale, Dr Z G Badade, Dr P E
Jagtap and Dr S K Ahaley
131
Abstract No: 2.28: Oxidative Stress, Antioxidants and Trace
Elements in Leprosy
Dr V B Londhe, Sevarina Madhale, Dr Z G Badade, Dr P E
Jagtap and Dr S K Ahaley
131
Abstract No: 2.29: Variations in Serum Ferritin, Electrolytes and
TIBC Levels in Paediatric Multitransfussed Thalassemic Patients
Jaidev Singh, Dr. (Mrs) Meena Varma and Dr.Sangeeta Paneri
132
Abstract No: 2.30: Study of Lead Content in Various Water Samples
within Bangalore and A Survey Based on Effects of Lead Poisoning
on People
Preeti Mangala, Javeria Anjum and Arpi Dey
133
Abstract No: 2.31: Evaluation of Lead Concentration in Milk and
Milk Products
Charanraj T.P, Anuj Ranjan, Alka Kumari, Arun Kumar, Kalpana
Devi.N and Sushma Bharti
134
Abstract No: 2.32: Effect of Lead on Employees Working in Paint
Industry
Hariprasad.B.N, Vinay.G, Vinay Kumar.C, Sathish
Kumar.P..and..Prof.Sripathy.L
134
Abstract no: 2.33: Vitamin D- Emerging Silent Lifestye Disease:
A Pilot Study
D. Radhika Chowdary and B. Naveen Kumar
135
Abstract No: 3.1: Myeloperoxidase in Chronic Kidney Disease
Usha Anand, Madhusudhana Rao.A, Vijaya D, Aruna V, Gayathri B
and Anand CV
136
Abstract No: 3.2: Serum Adenosine Deaminase Levels in Acute
Kidney Injury
Saleena Ummer V, Nalini K , Ravindra Prabhu and Licy CD
136
CONTENTS
Abstract No: 3.3: In vitro Studies on Anticalcifying Properties of
achyranthes aspera
Aggarwal A, Singla SK and Tandon C
137
Abstract No: 3.4: Correlation of Serum Intact Parathormone Level
with Biochemical Parameters in Various Stages of Chronic Renal
Failure Pateints
Bhimappa .N. M, Suma.M.N and H.S.Virupaksha
138
Abstract No: 3.5: Comparison of Serum Creatinine, Urinary
Creatinine and Urinary Beta 2 Microglobulin Levels as an Early
Marker of Subtle Renal Dysfunction due to Aminoglycoside
Therapy in Full Term Sick Neonates.
Dr Bonny B Jasani, Dr Rohini Bhadre, Dr Varsha and D. Phadke
139
Abstract No: 3.6: Observations on Microalbuminuria in
Hypertensives with Alcholism and / or Smoking
Dr.D.L.Lalitha, Dr.B.Sreehari babu, Mr.D.S.S.K.Raju and
Dr.P.K.Behera
139
Abstract No: 3.7: Serum Lipoprotein(a) and Lipid Profile in
Chronic Kidney Disease
Neela B M and Virupaksha H S
140
Abstract No: 3.8: Evaluation of Urinary Protein Bound Sialic Acid
and Protein Carbonyl content as the Prognostic Markers of
Nephrotic Syndrome in Pediatric Age Group
Niranjan G., Koner B.C and Bhat V.
141
Abstract No: 3.9: Oxidative Stress and Transforming Growth
Factor-Beta 1 (TGF-â1) in the Progression of Diabetic Nephropathy
Kavitha Gandhi and Dr.Rita Mary Aruna
141
Abstract No: 3.10: Hypothyroidism and Renal Impairment
K.Shanthi Naidu, M.R.Chakravarthi, Bipin Kumar Sethi,
Suryadeep Pratap, Syed Hyder Ali, BVLN Murthy and G.Surekha
142
Abstract No: 3.11: Oxidative Stress and Antioxidant Therapy in
Nephrotic Syndrome
Jyoti Dwivedi and Dr.Purnima Dey Sarkar
143
Abstract No: 3.12: Serum Cystatin C levels in Renal Transplant
Recipients
Krishnamurthy N , Usha Anand , Anand C V , Aruna V and Venu G
143
Abstract No: 3.13: Serum Zinc and Serum Copper Level in Renal
Diseases
Payasvi Baweja, B.K. Agrawal and V.K Sharma
144
CONTENTS
Abstract No: 3.14: Renal Function Screening in Neonatal Asphyxia
Prachi Paliwal, Dr.B.K.Agrawal, Dr.Rashmi Dwivedi and
Dr.Paliwal Manoj
144
Abstract No: 3.15: Exploring the Role of Lipids Isolated from
Human Renal Stone Matrix in Urolithiasis
Priyadarshini, Shrawan Kumar Singh and Chanderdeep Tandon
145
Abstract No: 3.16: Prevalence and Characterization of Renal
Tubular Acidosis in Patients with Myalgias, Osteoporosis and Mild
Arthritis.
Rachel Jacob
146
Abstract No: 3.17: Renal Calculi Analysis
K.Shanthi Naidu, Suryadeep Pratap, Zaheed Khan, Syed Hyder
Ali, S.M.Ismail, and A.Phani Kumar,
146
Abstract No: 3.18: Antioxidant Activity of Creatinine and Uric
Acid and Related Efficacy of Antioxidant to Inhibit Glycation
Rohit Suresh, Yogita S Phapale and Dr Z G Badade
147
Abstract No: 3.19: Carbamylated Haemoglobin: A Diagnostic
Marker for Chronic Renal Failure.
S.Subramaniam, ShyamaSubramaniam, M.K. Mani, Partha
Karmakar, K.Ezhil arasan, K.Dhananjayan and M.Gopinath
148
Abstract No: 3.20: Evaluation of Low Dose Doxycycline on Renal
Function in Diabetes with Nephropathy
S. Seth, P. Talapatra, H.K. Aggarwal and M. Seth
148
Abstract No: 3.21: The Effects of Kidney Function and
Transplantation on Plasma Electrolytes, Albumin and
Cardiovascular Risk
Thompson, M.J.W. and Ray, U.
149
Abstract No: 3.22: Tacrolimus in Renal Transplant Recipients
Dr.Pradeep Naik and Mallikarjuna .M
150
Abstract No: 3.23: Study of Microalbuminuria in Hypertension
Sharma, Ashutosh. ; Lal, A.K. ; Mehrotra, V and Verma, S.K.
150
Abstract No: 3.24: The Pattern of Nephrotic Syndrome in Malabar
region, Kerala
K Sreevidya and George Abraham
151
Abstract No: 3.25: Adiponectin Levels in Chronic Kidney Disease
and its Correlation with CRP, Cystatin-C and eGFR
Manjunatha.G.J and Vijay S.Bhat
Abstract No: 3.26: Effect of Smoking on Chronic Renal Failure
in Primary Glomerular Nephropathies
Prof.(Dr) Uday Kumar, Dr.A.Sharan and Dr Snigdha
152
153
CONTENTS
Abstract No: 3.27: The Effects of Kidney Function and
Transplantation on Plasma Electrolytes, Albumin and
Cardiovascular Risk
Thompson, M.J.W. and Ray, U.
153
Abstract No.3.28: Study of Urolithiasis in Gwalior Region
A.K. Bhargava, Neelima Singh, Sanjeev Singh, Pradeep Sharma,
Dharmveer Sharma, Sunil Agarwal and Sunita Sharma
155
Abstract No: 4.1: Cardiovascular Risk Markers in Hypothyroidism
Aparna R.Bitla, E. Jayanti, Alok Sachan, G. Shiva Krishna,
M.M.Suchitra, P.V.L.N.Srinivasa Rao, and KVN Raju
155
Abstract No: 4.2: Hyperhomocysteinemia, Circulating Folic acid
and Cobalamine Levels in Coronary Syndrome
Yadav AS, Bhagwat VR, Mane AY and Venugopal NT
156
Abstract No: 4.3: Insulin Resistance and Lipid Profile in Pregnancy
Induced Hypertension
Asmathulla S, Rajagovindan.D and Jakanattane
157
Abstract No: 4.4: Hypothyroidism Risk factor for Coronary Heart
Disease
B.K.Agrawal, Bhawna Bhimte, and V.K.Sharma
157
Abstract No: 4.5: Diabetes Accelerates Age-Related Lipid Profile
Disturbances
Zafar M.E. Nehal M. Teeto S.A. and Prasad K.R.
158
Abstract No: 4.6: Biochemical Study of Emerging Risk Markers
in Coronary Heart Disease
H.V. Singh, S.Bhandari, N.Singh, S.Singh and A.Raizada
158
Abstract No: 4.7: Anti-oxidant Potential (AOP) of LDL in Post
Menopausal Women Suffering from Type 2 Diabetes Mellitus.
Nivedita Singh, Neelima Singh, Sanjeev Singh and Vishal
Bhargava
159
Abstract No: 4.8: Increased Levels of Inflammatory Markers, Sialic
Acid and Cardiovascular Risk Factors in Type 2 Diabetes Mellitus.
Dr. S.Rajesh, Dr. S.Sethupathy and Dr.S.M.Rajendran
160
Abstract No: 4.9: Influence of Atherosclerosis and Exercise on
Arterial Lipoprotein Lipase Activity in Pigs
Shakti Aggarwal, Theodore W. Zderic, Perminder Gulani and
Marc T. Hamilton,
160
Abstract No: 4.10: Study of Apolipoprotein A-1, B and Lipid Profile
in Premenopausal and Postmenopausal Women
Dr. Swapnali and Dr. D.S. Jayaprakash Murthy.
161
CONTENTS
Abstract No: 4.11: Significance of Plasma Total Homocysteine
Levels in Type II Diabetes Mellitus Ppatients
Anbazhagan M and Ben S. Ashok
162
Abstract No: 4.12: Apolipoprotein A1 Gene Polymorphism (G75A and C+83T) in Patients of Myocardial Infarction- a Pilot Study
in North Indian Population.
Rajni Dawar, Anil Gurtoo and Ritu Singh
162
Abstract No: 4.13: Role of Pro-inflammatory Cytokines, ApoB
and Small Dense LDL in Women with Coronary Artery Disease
Sunita, S.B Sharma, D.Puri, R.L.Tripathi and S.Dwivedi
163
Abstract No: 4.14: Dyslipidemia and Anti-oxidant Nutrient in Preeclampsia
Dr.M.G.Dhabe, Dr. (Mrs.)S.C.Choudhary and Dr.M.R.Mogarekar
164
Abstract No: 4.15: Post Coronary Stenting Decrease in Atherogenic
Risk Factors
Kavitha.S, Sridhar M.G, Satheesh.S and Balachander J
164
Abstract No: 4.16: Serum Uric Acid in Acute Myocardial Infarction
Gargi Sen and Virupaksha H. S.
165
Abstract No: 4.17: Apolipoprotein B, Total Cholesterol, HDL-C,
Non HDL-C, LDL-C and Triglycerides as Risk Factors of
Atherosclerotic Vascular Disease
Jitty George, Dr.Andrews M.A, Dr.Cibu Mathew, Dr.Geetha
Damodaran K, and Dr.Gilsa E
165
Abstract No: 4.18: Accuracy of Retinal Changes in Predicting
Microalbuminuria in Obese and Non-obese Hypertensive Patients.
Arul Senghor, Ebenezer William and Jothimalar
166
Abstract No: 4.19: Circulating Levels of Cell Adhesion Molecules
in Hypertension
Kavita K. Shalia, Manoj R. Mashru, Jagdish B. Vasvani, Rajashree
A. Mokal. Shilpa M. Mithbawkar and Priti K. Thakur
167
Abstract No.4.20: Serum Paraoxanase Activity and its relationship
with Atherogenic Index of Plasma (AIP) in Hyperlipidemic Patients
Kavya R, Phani M.N, Supriya M, Jeevan K.Shetty and Mungli
Prakash
167
Abstract No: 4.21: Trends in Blood Pressure with Increasing Serum
Homocysteine Levels
Kumar. Animesh, Gupta P.R and Ali.Z
168
Abstract No: 4.22: Coronary Heart Diseases and Serum
Triglycerides
K Ram achandran, Divya K.V., Ajeena and Sheela
168
CONTENTS
Abstract No: 5.1: Investigation Profile Correlated with Adverse
Maternal and Perinatal Outcome in Pregnancy Induced
Hypertension (PIH)
Ms.Liggy Andrews, Dr.N.Haridas and Dr. Smruti Vaishnav
169
Abstract No: 5.2: Status of Lipid Profile in Patients of Acute
Myocardial Infarction
K.Suchitra, Bari Siddiqui M. A and U.Satyanarayana
170
Abstract No: 5.3: A Study of Age Related Changes in the Serum
Lipid Levels in Healthy Adults of Mangalore City
Dr.Malathi.M and Ms.Sangita Kamath
171
Abstract No: 5.4: Systemic Failure of Interferon-á synthesis, a
Potent Inhibitor of Platelet Aggregation and a Thrombolytic Agent,
and its Role in the Development of Acute Myocardial Infarction.
Mau Bhattacharyya and Asru K. Sinha
171
Abstract No: 5.5: Atherogenic Index in Patients with Established
Myocardial Infarction.
Abdul Lateef , Afshan Rafi and Pragna Rao
172
Abstract No: 5.6: Increased Cardio Metabolic Risk Factors seen
in School Cildren
Sumathi, Meera, Vinodhini and Ebenezer William
173
Abstract No: 5.7: Assessing Risk Factors in Acute Coronary
Syndrome
Moushumi Lodh, Ashok Parida and Alpana Saxena
173
Abstract No: 5.8: Atherogenic Index of Plasma in Ischaemic Heart
Disease Patients.
Phani M.N, Supriya.M, Kavya R, Jeevan K.Shetty and Mungli Prakash
174
Abstract No: 5.9: Current Biomarkers for Myocardial Infarction
Rathish.R and Sumathi.P
174
Abstract No: 5.10: Appearance of Dermcidin, a Heat Shock Protein,
as a Risk Factor for Acute Ischemic Heart Disease through the
Inhibition of Pancreatic Insulin Synthesis
Rajeshwary Ghosh and Asru K.Sinha
175
Abstract No: 5.11: Uric Acid Levels in Cardiovascular Disease
Mrs. Ranjita V.Gaur and Dr.(Mrs.)Rita M.Shah
176
Abstract No: 5.12: Effect of a Single Dialysis Session on Plasma
Lp(a) Levels in Patients on Maintenance Haemodialysis
Seshadri Reddy. V, M.M. Suchitra, E. Prabhakar Reddy, Aparna
R.Bitla, V. Sivakumar and P.V.L.N. Srinivasa Rao
176
CONTENTS
Abstract No: 5.13: Association of LDL Particle Size with other
Cardiovascular Risk Markers in an Industrial Population.
Mohammad Tarik, Lakshmy Ramakrishnan, Ruby Gupta, Dorairaj
Prabhakaran and Kolli Srinath Reddy
177
Abstract No: 5.14: A Novel Antihypertensive Protein Hormone
from the Kidney Cortex, and its use for the Diagnosis of Essential
Hypertension in Men.
Somashree Chakraborty, Gausal A. Khan and Sinha A.K
177
Abstract No: 5.15: Ischemia Modified Albumin – an Evolving
Diagnostic Marker of Myocardial Ischemia
Dr Sudeshna Behera and Prof. P.C.Mohapatra
178
Abstract No: 5.16: Study of Serum Magnesium, HbA1c , Lipid
Profile and Microalbuminuria in Diabetic Retinopathy
Swetha N K and Virupaksha H S.
179
Abstract No: 5.17: The Effects of Kidney Function and
Transplantation on Biochemical Correlates of Cardiovascular
Health
Thompson. M.J.W and Ray.U.
179
Abstract No: 5.18: Utility of NT proBNP in a Wider Range
K.Shanthi Naidu, Suryadeep Pratap, Syed Hyder Ali, BVLN
Murthy, B.Goud, B.Raghavendra and J.Visalasree
181
Abstract No: 5.19: Normalization by Aspirin of Hypertension for
the Reduction of Risk of Coronary Artery Disease in Men
Uttam K. Maji and Asru K. Sinha
181
Abstract No: 5.20: A Study of Insulin Levels in Pregnancy Induced
Hypertension
Vinodhini, Meera Shivshekar and Ebenezer William
182
Abstract No: 5.21: Levels of GHBA1C in Non- diabetic Patients
with Cardiovascular Disease
Tarun Kumar Sharma, H. Parchwani, G.G. Kaushik and Vijay
Shankar
182
Abstract No: 5.22:Biochemical Markers and Coronary Occlusion
in Patients Undergone Coronary Arteriography
Bhagwat V.R, Venugopal N.T, Yadav A.S and Mane A.Y
183
Abstract No: 5.23: Cytomegalovirus and Coronary Heart Disease
Asif.A.
183
Abstract No: 5.24: Role of “Ischemia Modified Albumin” in the
Early Diagnosis of Acute Coronary Syndromes
B.Gayathri, D.Vijaya, B.Bini, Usha Anand, V. Aruna and C.V Anand
184
CONTENTS
Abstract No: 5.25: Inflammatory Markers in Arterial
Prehypertension and Hypertension
Manjrekar AP, D’Souza V, Hegde A, Adhikari P and CV
Raghuveer
185
Abstract No: 6.1: A Spectrum of Paraproteinemias
K.Shanthi Naidu, P.Srikanth, Shailesh.S, M.R.Chakravarthy, Syed
Omar, Kishore, A.Suhasini and Visalasree
185
Abstract No: 6.2: Effective POCT : the Need for a Broader
Perspective
A.K.Srivastava
186
Abstract No: 6.3: Biochemical Markers in Osteoporotic Hip
Fractures
Dr.Meera.S , Dr.M.Sukharaja , Dr.B.G.Sagar and N.Kantharaj
186
Abstract No: 6.4: Metabolic Dearrengements in Births Asphyxia
Occurring as a Result of Cellular Injury.
Amrita Vamne, B. K. Agrawal and Jyotsana Shrivastava
187
Abstract No: 6.5: Evaluation of Salivary Cholinesterase and
Ceruloplasmin in Children with Attention Deficit Hyperactivity
Disorder
Bhavya Prabhu.K, Archana E, Priya Pai, Dr. Krishnananda Prabhu
and Dr. Anjali Rao
188
Abstract No: 6.6: Cheek Cell Epithelium: a Non Invasive Specimen
for Measurement of Fatty Acid Intake
Ransi Ann Abraham, Lakshmy Ramakrishnan ,Ruby Gupta, Smita
Golandanz, Rajinder Parshad, V K Bahl, Ambuj Roy, R M Pandey,
Dorairaj Prabhakaran and Kolli Srinath Reddy
188
Abstract No: 6.7: Coagulation Deficiencies in a Referral
Laboratory
K.Shanthi Naidu, P.Srikanth, Shailesh.S, D.Ramesh, D.Ramana,
B.Raghavendra, B.Goud and B.Siva Mallika
189
Abstract No: 6.8: Coagulation Studies in Neonatal Critical Care
K.Shanthi Naidu, P.Srikanth, Shailesh.S, D.Ramesh, D.Ramana,
B.Raghavendra, B.Goud, B.Siva Mallika and S.M.Ismail
190
Abstract No: 6.9: A Case of Xanthochromia
Ashish Sharma, N. Haridas, S. Ghosh, Hitesh Shah ,Kiran and Uday
190
Abstract No: 6.10
CONTENTS
Abstract No: 6.11: The Potential Significance of Procalcitonin and
Interleukin-6 in Prediction of Survival in Patients with Sepsis
S. Das, S. Bhargava, A. Manocha, M. Kankra and L.M.Srivastava
191
Abstract No: 6.12: Immunological Studies on Glycated and
Glycoxidated LDL: Implications in the Pathogenesis of Various
Diseases
Salman K A, Alam.R, Arif.N and Khan.S
192
Abstract No: 6.13: Critical Call Back – An Experience in a Tertiary
Care Hospital
Dr. Mohammad Ibrahim, Maj Dr. Ikramul Islam (Retd), Prof (Dr.)
Tareak-Al-Nasir and Lt.Col Dr. Debashish Saha
193
Abstract No: 6.14: Rare cases of Pagets Disease of the Bone in
India: Biochemical and Clinical Evaluation and Follow-up in 2
Extreme Presentations
Dr CS Muralidhara Krishna ,Dr H L Vishwanath ,Dr S Sanjay, Dr
Tejeswini Deepak, Dr.A Sharda and Dr.S.S Srikanta
193
Abstract No: 6.15: Role of Acute Phase Proteins in the Prognosis
of Head Injury
P Sumathi and M K Balasubramanian
194
Abstract No: 6.16: Biochemical Profile of Cord Blood in Normal
Pregnancy and Pregnancy Induced Hypertension.
Miss D.Prathima , Dr. U.B.Vijaya lakshmi and Prof. Dr. K.
Ambika Devi
195
Abstract No: 6.17: Comparision of Plasma Phosphdiesterase
Activity in Premenstrual and Menstrual Period.
Rajyalakshmi M, Indu R Warrier, Dr. Krishnananda Prabhu and
Dr. Anjali Rao
196
Abstract No: 6.18: Serum Calcium, Phosphorus and Alkaline
Phosphatase Levels in Preterm Babies.
Sarika Singh Chauhan, B. K. Agrawal and Rashmi Dwivedi
196
Abstract No: 6.19: Study of Effect of Phototherapy on Neonatal
Hyperbilirubinemia
M.Vijay and M.Malathi.
197
Abstract No: 6.20: SMS Tube : A Novel Way of Giving Specimen
Collectors 24/7 Mobile Access to Our Specimen Requirements
Database
T F Hartley, W. Bowling, Sharon Fong, A, Gibb, K Hen, B Hitchens,
Renee Twynam-Perkins, K Wilson, J Zhang and Nicole Herbert
198
CONTENTS
Abstract No: 6.21: Storage Stability of Glycosylated Hemoglobin
in Red Blood Cells and Dried Blood Spots
Ruby Gupta, Ramakrishnan Lakshmy, Dorairaj Prabhakaran and
Kolli Srinath Reddy
199
Abstract No: 6.22: Data Analysis of Biochemical Values in a
Polyclinic and Diagnostic Centre in Dumdum, Kolkata
Dr.Aditi Sen (Sarkar), Sanchari Halder, Anirban Ganguly,
Mononjay Banerjee, Ramkrishna Bhattacherjee and Dr. Papia
Mukherjee
200
Abstract No: 6.23: Evaluation of Salivary Magnesium and Protein
Thiols in Children with ADHD
Archana E, Bhavya Prabhu K, Priya Pai, Dr. Krishnananda Prabhu
MD, Dr. Anjali Rao and Dr. Revathi P. Shenoy
201
Abstract No: 6.24: Estimation of Creatinine in Sweat
Shivaraj Gowda, Prakash Desai, Avinash A K Math, Sonal
Vernekar, Shruthi Kulkarni, Vinayak Hull and Mahantesh Ilkal
201
Abstract No: 6.25: Reference Range for Serum Total Alkaline
Phosphatase in Healthy Individuals
Kiran Kumar B , Nalini Ganesan and Anbazhagan M
202
Abstract No: 6.26: Quality Control Evaluation using Quality
Indicators - Experience of a Clinical Laboratory in Delhi
A Manocha, S Bhargava, M Kankra, S Das and LM Srivastava
203
Abstract No: 6.27: Quality Indicators for Measuring the Process
Performance of a Clinical Laboratory
Dr.R.Balambal
203
Abstract No: 6.28: Serum Protein Electrophoretic Pattern of
Chronically ill Patients in a Tertiary Care Hospital
Vijayasree.N
204
Abstract No: 6.29: Immunocharacterisation of Polyclonal and
Monoclonal Antibodies Raised against Cobra Venom Toxin
Lakshmi.A , Dr. K.S.Vasudevan, Mr.A.Mathialagan and
Dr.S.Subramanian
205
Abstract No: 6.30: Development of a Novel Method to Eliminate
the Negative Interference of Bilirubin on Creatinine Assay by
Jaffe’s Kinetic Method in Icteric Sera.
M.M.Goyal and A.Basak
206
Abstract No: 6.31: Clinical Biochemistry : The Goldmine of
Challenges and How do we face it
K. Sorte, K. Palandurkar, M.M. Goyal and A.Basak
206
CONTENTS
Abstract No: 6.32: Hyperhomocysteinemia and Folic Acid, Vitamin
B12 Levels and their Correlation in Eclampsia
Shahid A. Mujawar, Vinayak W.Patil, Rekha G. Daver and
Narayan A. Madrasi
207
Abstract No: 7.1: The Association between Serum Alkaline
Phosphatase and ABO Blood Group
E.Sruti, Nalini Ganesan and Anbazhagan.M
207
Abstract No: 7.2: Guidelines and Recommendation for Laboratory
Analysis in the Diagnosis
Dr. Alok Parekh, Dr.Maulik Nayak, Dr.Rita Shah and Dr. D.A.
Trivedi
208
Abstract No: 7.3: Establishing a Reference Range for Thiopurine
Methyltransferase (TPMT) Activity in Indian Populations
Jayashree.T, Sadik A. Mahammad, Ramchandra Rao.O,
Rupa Banerjee and Nageshwar Reddy.D
208
Abstract No: 7.4: Biochemical Impact of Lumirubin in Neonatal
Hyperbilirubinemia
P.S Kamble, R.K Padalkar, P.D Zende and V.R Pandhare
209
Abstract No: 7.5: Comparison of Cord Blood Atherogenic Index
in Males and Females
Kharb.S and Smiti Nanda
210
Abstract No: 7.6: Quality Control in Clinical Chemistry: Minimal
Requirements for an Acceptable Program
Dr. Manju Bala Pahwa and Dr. Veena Singh
210
Abstract No: 7.7: Quality Indicators: A Tool for Continuous Quality
Improvement in Clinical Laboratories
S.Subramaniam and Shyama Subramaniam
211
Abstract No: 7.8: Serum Sodium and Potassium Level in Emesis
Gravidarum
Sana Hasan, Dr. B.K.Agarwal and Dr. Neelkamal Kapoor
211
Abstract No: 7.9: Study of Serum Fluoride and Sialic Acid Levels
in Osteosarcoma
Sandhu.R, Lal.H, Kundu Z.S and Sandeep, Kharb.S
212
Abstract No: 7.10: Prevalence of Diabetes Mellitus in Urban
Region of Chennai City- a part of Purse- HIS study
Satyajeet Giri, S.Thanikachalam and K.Sowmya
212
Abstract No: 7.11: A Study of Serum Ferritin Levels in Type -2
Diabetic Patients
Shiv Ram Krishn and Ekta Agarwal
213
CONTENTS
Abstract No: 7.12: Comparison of Serum and Plasma Uric Acid
Dr. Shivraj Gowda, Dr. P.B. Desai, Shruti Kulkarni, Sonal Vernekar,
Avinash A.K.Math, Vinayak Hull and Mahantesh Ilkal
213
Abstract No: 7.13: Tourniquet: Lacunae of Preanalytics
Smita S.Sonoli, and Anuradha B.Patil
214
Abstract No: 7.14: Simplified Procedure for Cholesterol
Determination
Dr. Shivraj Gowda, Dr. P.B. Desai, Sonal N. Vernekar, Vinayak
Hull, Avinash A.K.Math, Shruti Kulkarni and Mahantesh Ilkal
214
Abstract No: 7.15: Study of Lipid Profile and Glycosylated
Hemoglobin (HbA1 C) in Patients of Diabetes Mellitus
Tripti Saxena, B.K. Agrawal, and V.K. Sharma,
215
Abstract No: 7.16: Use of Tris-Borate Buffer in Agarose Gel
Electrophoresis of Serum Proteins
Mahesh S, Naureen Anwar, Yeshoda K, Saifa Yasmin and Dr. Nalini K
216
Abstract No: 7.17: Use of the Laboratory in Prediction of Outcome
in the High-Risk Newborn
Dr. Alok Parekh, Dr.Maulik Nayak, Dr.Rita Shah and Dr. D.A. Trivedi
216
Abstract No: 7.18: Standardization of DAM Method by Single
Step
Dr. Shivraj Gowda, Dr. P.B. Desai, Vinayak Hull, Avinash
A.K.Math, Shruti Kulkarni, Sonal Vernekar and Mahantesh Ilkal.
217
Abstract No: 7.19: Effect of Feeding Practices in Neonatal
Hyperbilirubinemia Subjects
P.D Zende, R.K Padalkar, P.S Kamble and V.R Pandhare
217
Abstract No: 7.20: Novel Therapeutic Properties of Nano Silver*
Siddhartha Shrivastava, Sunil Singh and Debabrata Dash
218
Abstract No: 7.21: Evaluation of Procalcitonin as a Diagnostic
Marker of Sepsis
Ms. Nandini C and Dr.N.Leela Menon
219
Abstract No: 7.22: Comparison of Various Parameters with Serum
Free Light Chain Assay in the Diagnosis of Multiple Myeloma
Mrudula E.V and Dr.Sajitha Krishnan
219
Abstract No: 7.23: Importance of Tacrolimus Measurement and
Assessment of its Toxicity in Monitoring Post Liver Transplant
Patients
Anuja.P.S, Dr. K.N. Subhakumari and Dr. Jagathlal.P.C
220
Abstract No: 7.24: Six Sigma Analysis of Performance of Routine
Chemistries at a Hospital lab
Rashmi and Dr. Narayani
221
CONTENTS
Abstract No: 8.1: Hepatitis B Virus Sequence Database for Indian
Isolates and Mutation Profiling Tool
Amit Tuteja, Kaushal Madan, Subraya K. Acharya,
Dr. K.Narayanasamy and Dr. Swati Subodh
221
Abstract No: 8.2: Association of Antioxidant Enzyme Gene
Polymorphism in ATT Induced Hepatotoxicity in North Indians
S.V. Rana, Sanjeev K. Sharma, R.P. Ola, S.K. Sinha, J. Kaur, and
K. Singh.
222
Abstract No: 8.3: Circulating Plasma DNA as a Diagnostic Tool –
A Review
K.Ramadevi
223
Abstract No: 8.4: Polymorphism of p53 Gene Codon 72 in Indian
Hyperlipedimic Patients with Cardiovascular Disease
K Ezhilarasan, K Dhananjayan, K.Anbarasu, A Sampath kumar, A
K.Munirajan, Shyma Subramaniam and S.Subramaniam
223
Abstract No: 8.5: Silver Nanoparticles - Potential Antiplatelet /
Antithrombotic Agents
Debapriya Bandyopadhyay and B.K Gupta
224
Abstract No: 8.6: Rapid Detection of Mutation in RRDR of rpo B
Gene for Rifampicin Resistance in MDR-Pulmonary Tuberculosis
by DNA Sequencing
Dr Surajeet Kumar Patra, Dr Anju Jain, Dr B L Sherwal and Dr
Ashwani Khanna
225
Abstract No: 8.7: Apo E Genotyping from Blood Stored on Filter
Paper
Rizwana Quraishi, Ramakrishnan Lakshmy,
Ashok K. Mukhopadhyay and Bansi L Jailkhani
225
Abstract No: 8.8: Angiotensin Converting Enzyme Gene Insertion
Deletion (I/D) Polymorphism and its Association with
Microalbuminuria in Essential Hypertension
K.Ramalingam , K.Santha , S.Sethupathy and R.Vinoth Kumar
226
Abstract No: 8.9: Association of Antioxidant Enzyme Gene
Polymorphism in ATT Induced Hepatotoxicity in North Indians
S.V. Rana, Sanjeev K. Sharma, R.P. Ola, S.K. Sinha, J. Kaur and
K. Singh.
227
Abstract No: 8.10: Expression of Myogenin and CD105 in
Autologous Bone Marrow Derived Mesenchymal Stromal Cells
of Duchenne Muscular Dystrophy Patients.
Dr. Sumit Jhajharia, Dr Prakash C.Mohapatra, Debashish Das and
Sujay Singh
227
CONTENTS
Abstract No: 8.11: Somatic DNA Damages in Cardiovascular
Autonomic Neuropathy
Supriya Simon A, Jayapal V and Dinesh Roy D
228
Abstract No: 8.12: Interaction of Iron Deficiency Anaemia and
Alpha Thalassaemia in the Population
Tapash Rudra, Sila Chakrabarti and Bani Sengupta
228
Abstract No: 8.13: Potential of Mycobacterial Excretory Secretory
Protein Antigens (SEVA TB ES-31, ES-43, EST-6 and ES-20) as
Biomarkers to detect Mycobacterium tuberculosis Bacilli
Anindita M, Thamke.D, Mendiratta D.K and Harinath B.C
229
Abstract No: 8.14: Reliability of Pleural Fluid ADA as a Marker
for Exudates
Mr.D.S.S.K.Raju, Dr.D.L.Lalitha, Dr.B.Sreehari Babu and
Mr.M.Anil Kumar
230
Abstract No: 8.15: Computational Studies of the Interactions of
Some Inhibitors with HIV-1 Protease
Rajkumari Rathore, Savita Rathore, Neha Sharma and Anil Bidwai
230
Abstract No: 8.16: Auto Antibody in The Cases Of Neurological
Disorder
Dr.Anand Saran,Mr.S.S.Haque, Dr.Ashok Kumar and Dr.Uday Kumar
231
Abstract No: 8.17
Evaluation of Serum Adenosine Deaminase Activity and Lipid
Profile in Type 2-Diabetes Mellitus
M.M.Suchitra, S.Aruna, K.V.N.Raju, K.Deepthi, V.Suresh, Aparna
R.Bitla and P.V.L.N.Srinivasa Rao
232
Abstract No: 8.18: Immunodiagnostic Evaluation of Recombinant
Filarial Antigen rWbL2.
Mahendra B.Gandhe, B.V.Sivaprasad.,Kiran Pote and
M.V.R.Reddy
232
Abstract No: 8.19: Immunomodulatory and Respiratory Burst
Killing Activity of Pyrazine-2-Carbohydrazide Derivatives
P.B.Miniyar and S. J. Makhija
233
Abstract No: 8.20: Serum Lactate – Not a Good Marker of Disease
Severity in Adults With Plasmodium Falciparum Infection
Dr.Rina Triparthy and Dr.Bidyut Kumar Das
234
Abstract No: 8.21: Altered Renal Profile and Liver Function Test
in Case of Complicated Plasmodium Falciparum Malaria
Shivaraj Gowda, Prakash B Desai, Sindhu J Shetty, Vijayetha S
Kagwad and Mahantesh B. Ilakal
234
CONTENTS
Abstract No: 8.22: A Study on Acute Phase Proteins and its
Relationship with Hemoglobin in Anemic Pulmonary Tuberculosis
Patients
Subodh Kumar, Kiran Saxena, Rashmi A Kulkarni, Avanish Mishra,
Ramesh Pradhan, Rosy L.Pradhan and A.R.S Sinha
235
Abstract No: 8.23: Plasma levels of Interleukin-6 and Interleukin10 in Rheumatoid Arthritis
Vasanthi Pallinti, Nalini Ganesan and Rajasekhar.G
236
Abstract No: 8.24: Anti - CCP Auto Antibodies in Rheumatoid
Arthritis
Vinod AN, Nalini Ganesan and Rajasekar
236
Abstract No: 8.25: Molecular Mechanisms Underlying the Effect
of Papaya Seed Products in Regulating Male Fertility
N. Pathak, R. M. Samartha, D. Jain, K. K. Maudar, S. Tiwari, S.
Gupta and P. K. Mishra
237
Abstract No: 8.26: Prevalence of HCV Genotypes and Significance
of TH1/TH2 Cytokines in Response to Combination Therapy: A
Pilot Study from Central India
P. K. Mishra, A. Bhargava, R. P. Punde, S. Tiwari, P. Vashistha, S.
Varshney and K. K. Maudar
238
Abstract No: 8.27: Diagnosis of Mycobacterial Tuberculosis
Complex (MTBC) in Endoscopic Biopsy Samples and ParaffinEmbedded Tissue Specimens Using Real Time PCR: Implications
in Patient Care
G.V. Raghuram, A. Bhargava, R.P. Punde, S.Varshney, K.K. Maudar
and P. K. Mishra
239
Abstract No: 8.28: Mediators of Immune System and Their Possible
Role in Pathogenesis of Chronic Hepatitis B and C Viral Infections
R. P. Punde, A. Bhargava, S. Gupta, S. Varshney, P. Vashistha, K.
K. Maudar and P. K. Mishra
240
Abstract No: 8.29: Electrophoresis and Immunochemical
Quantitation of Serum IgG, IgA, and IgM in Multiple Myeloma
and Study of Complications in Multiple Myeloma
Dr. Sajitha Krishnan and Toni Thomas
240
Abstract No: 8.30: Comparative Evaluation of Recombinant
WbSXP-1 Antigen and B.Malayi Microfilarial Antigens in the
Detection and Management of Bancroftian Filariasis
Partha Sarathi Pal, Gajalakshmi Dakshinamoorthy, Sivaprasad BV
and M.V.R Reddy
241
CONTENTS
Abstract No: 8.31: Oxidalitive Stress and Immunity Status in
Leprosy
V.B.Londhe, Sevesina P. Madhale, Z.G..Badade, P.E Jagtap,
S.K Ahaley and M.M Chavan
242
Abstract No: 8.32: Real Time PCR Quantitation of Minimal
Residual Disease (MRD) in Acute Lymphoblastic Leukemia
(ALL).
K.J Suneetha, K.Nirmala Nancy, K.R Rajalekshmy, T.G Sagar and
T.Rajkumar
242
Abstract No.8.33: Role of GST Polymorphisms in the
Susceptibility and Outcome in Acute Lymphoblastic Leukemia
K.J Suneetha, K.Nirmala Nancy, K.R Rajalekshmy, T.G Sagar and
T.Rajkumar
243
Abstract No: 9.1: CSF Calcium and Magnesium (Ionic and Total)
Levels: a Preliminary Study
Asharani.N, Sindhu, Samson Sujit Kumar.G, Ramakrishna and
Ramalingam.K
244
Abstract No: 9.2: Serotonin, Dopamine and Norepinephrine
Functional Regulation of DA D1 Receptors in Unilateral Rotenone
lesioned Parkinson’s Rat Model.
Jes Paul, Nandhu M.S, Korah P. Kuruvilla and C.S.Paulose
244
Abstract No: 9.3: Dopamine D1 Receptor Up Regulation In
Cerebellum and Brain Stem In Unilateral 6-Hydroxy Dopamine
Rat Model: Antagonism By Serotonin And Gamma Amino Butyric
Acid
Nandhu. M. S, Jes Paul, Korah P Kuruvilla and C S Paulose*
245
Abstract No: 9.4: Status of Enzymatic and Non-Enzymatic AntiOxidant Systems in Patients with Acute Ischemic Stroke
J. Sudha Rani
246
Abstract No: 9.5: Nitric Oxide and Lipid Profile in Type II Diabetes
Mellitus— A Case Control Study in East Sikkim
Dr. A. Ghosh, Ms. Y. Bhutia, Dr. T .A. Singh and Dr. M.L Sherpa
246
Abstract No: 9.6: Blood Glucose in Small for Gestational Age
Infants
Arvindkumar Chowdhary, R Nisarga, C.S Muralidhara Krishna
and K.L Mahadevappa
247
Abstract No: 9.7: Insulin Resistance and Lipid Profile in Pregnancy
Induced Hypertension
Asmathulla.S and Rajagovindan D. Jakanattane
248
CONTENTS
Abstract No: 9.8: Thyroid Satus in Hspital Bsed Cses from Rajendra
Institute of Medical Sciences, Ranchi
Dr K. K. Sinha and Dr. B. R. Ekka
248
Abstract No: 9.9: Effect of Iron Deficiency Anemia on
Glycosylated Hemoglobin Levels in Type 2 Diabetics.
Dr.B.Shanthi M.D
249
Abstract No: 9.10: Minerals Status in Thyroid Disorders (Hypo &
Hyper thyroidism)
B.Suneel, D.R.Nagendra, K.Ramalingam and J.N.Naidu
249
Abstract No: 9.11: The Role of Salacia Oblonga in Maintaining
Glucose and Lipid Homeostasis in Diabetic Rats
Bhagyajyothi.D , Dr.Vivian D’Souza , Dr.Poornima Manjrekar and
Dr. C.V. Raghuveer.
250
Abstract No: 9.12: Glycemic Control and Complications of
Diabetes Mellitus
Adiga Usha and Adiga M.N.S
250
Abstract No: 9.13: Relationship of Staple Diet and Abnormal
Thyroid Function Observed in Outpatients at Ujjain (MP)
Mane A. Y., Bhagwat V. R., Potey G.G and Gaikwad S.B
251
Abstract No: 9.14 Evaluation of Cardiovascular Risk Markers in
First Degree Relatives of Type 2 Diabetes Mellitus
H. Nandeesha, V. Sathiyapriya, Zachariah Bobby, Aparna Agrawal
and N. Selvaraj
251
Abstract No: 9.15: Lipid Profile and Glycemic Status in Nonsmoking Type 2 Diabetes Mellitus on Treatment with Oral
Hypoglycemic Drugs
J. Sandhya, B.R.Shyam Prasad, and U.Satyanarayana
252
Abstract No: 9.16: Thyroid, Lipid and Glycemic Profile in
Dyslipidemia and Altered Thyroid Status
Dr.Sridevi , Dr.Vivian D’souza, Dr.Poornima Manjrekar and
Dr.Vinit Anand
252
Abstract No: 9.17: Incontrovertible Behavior of Oxidative Stress
in Etiopathogenesis of Diabetes Mellitus or its Complications is
Disputable
P.P. Singh, Anu Chandra, Chetna Vashishtha, Farzana Mahdi and
Abbas Ali Mahdi1
253
Abstract No: 9.18: A Comparative Analysis of Anthropometric
Measurements, Lipid Profile, Fasting Insulin and HOMA2-IR to
Identify Insulin Resistance in Overweight Individuals
Dr.M.D.Sreenivasa Murthy, Dr. Manjunath M.Tembad and
Dr. Jayaprakash Murthy D.S
254
CONTENTS
Abstract No: 9.19: Thyroid Hormone Levels in New Borns of
Mothers with Gestational Diabetes
Dr.Geetha A, Dr. Joseph P. Thyparambil, Dr. Sreekumari.S
and Dr.Sulekha.B
255
Abstract No: 9.20: Lp(a) in Hypothyroidism
F.S.Geethanjali, M.S. Seashadri and A.S. Kanagasabapathy
255
Abstract No: 9.21: Role of Myelin Oligodendrocyte Glycoprotein
and Galactocerebroside Antibodies on Phosphorylation and
Degradation of Myelin Basic Protein In Isolated Myelin:
Implications in Multiple Sclerosis.
Krishnakumar Menon, Sidhy Viha C.V, Krishna Prasad G.N. and
Claude C.A. Bernard
256
Abstract No: 10.1: Glycosylated Hemoglobin Levels in Relation
to Antioxidant Status and Lipid Profile in Type 2 Diabetes Mellitus
Patients
Prasiddha Tilak, Mahesh S, Naureen Anwar and Dr Mungli Prakash
257
Abstract No: 10.2: Lipid Indices in Type 2 Diabetes Mellitus and
Their Association with Macro and Micro-vascular Complications
Dr. Imran Ahmed Siddiqui , Dr. J Rama Rao and Dr. Prabhavati
Modi
257
Abstract No: 10.3: Evaluation of Prothrombin Time and Activated
Partial Thromboplastin Time in Type-2 Diabetes.
Dr. Itishri Jena and Prof. Prakash Ch. Mohapatra
258
Abstract No: 10.4: Effect of Trigonella Foenum Graecum and
Insulin on Altered Membrane Functions in Alloxan Diabetic Rat
Brains
Pardeep Kumar, Asia Taha, R.K. Kale and Najma Zaheer Baquer
258
Abstract No: 10.5: Metabolic Syndrome in Type 2 Diabetes
Mellitus
Priya.K.Dhas, Janet, Shantharam and Dr. Rita Mary Aruna
259
Abstract No: 10.6: Study of the Effects of HCN Exposure in
Cassava Workers
Priya.K.Dhas, P.Chitra and Dr. Rita Mary Aruna
260
Abstract No: 10.7: Prevalence of Obesity in Female Students
Residing in Hostels in the University Campus of Manipal
Rosemol Jacob M, Yeshoda K, Elsa Maria, Uma Pallavi, Asha
Kamath, Dr. Revathy P Shenoy and Dr. Anjali Rao
260
Abstract No: 10.8: In vitro Effect of Visfatin on Glucose Utilization
by Visceral Adipose Tissue
Radhika G, Magnus J, Sasikala M, Venkat Rao G, Pradeep Rabella,
and Nageshwar Reddy.D
261
CONTENTS
Abstract No: 10.9: Salivary Cortisol Level in Depression Patients
Sukanya Shetty, Suhas Pattar, Satheesh Rao and Srinivas Bhat
261
Abstract No: 10.10: Atherogenic Index of Plasma and its
Relationship with Fasting Blood Glucose in Diabetes Mellitus
Patients.
Supriya M, Kavya R, Phani M.N, .Jeevan K Shetty and Mungli Prakash
262
Abstract No: 10.11: Lipoprotein (a), Fibrinogen, C – Reactive
Protein, Uric Acid and Microalbuminuria in Coronary Artery
Disease and Diabetes Mellitus”
Suvarna.T. Jadhav, Dr. A.V. Sontakke, Dr. B.M. Tiwale and
Dr. Mrs. C.C.Khanwelkar
263
Abstract No: 10.12: Is hsCRP an Independent Risk Factor in Type
2 Diabetes?
Dr.V.S. Kalaiselvi
263
Abstract No: 10.13: Oxidative Stress and Proteolytic Activity in
Erythrocytes of Diabetic Patients
Dr. Varashree B S and Dr.P.Gopalakrishna Bhat
264
Abstract No: 10.14: Leptin Levels in Early Post Transplant Period:
Can it be Used to Assess Changes in Body Composition ?
Victoria Job, Venkataramana Raju and George T. John
265
Abstract No: 10.15: Inhibition of Type I 5á-reductase
Vijaya Patil, Debjani Dasgupta,, Grace Samual, Shubhangi
Mirapurkar and Krishnamohan
265
Abstract No: 10.16: Thyroid Function in Diabetic Subjects
Ranjani.P and Vijaya Srinivasan
266
Abstract No: 10.17: Atypical Findings of Oral Glucose Tolerance
Test (OGTT) Curve in Gestational Diabetes Mellitus (GDM)
Shivaraj Gowda, P B Desai, Vijayetha S Kagwad, Sindhu J Shetty
and M B Ilakal.
267
Abstract No: 10.18: Insulin Level in Obese Patients with
Obstructive Sleep Apnea Syndrome.
Yogendra Singh, Surya Prakash Bhatt, Randeep Guleria and
Manjit Singh Dhillo
267
Abstract No: 10.19: Study of Lipid Profile, Oxidative Stress and
Enzymatic Antioxidant in Type-2 Diabetes Mellitus
Youb Raj Neupane, Dr Sandeep Roy and Dr Z G Badade
268
Abstract No: 10.20: Assay of CRP and HbA1C in Smokers and
Nonsmokers with Type 2 Diabetes Mellitus in a Segment of Indian
Urban Population
Rajyalakshmi Amancherla and Pradeep Naik
268
CONTENTS
Abstract No: 10.21: Association of ApoA5 1131 T>C
Polymorphism with Triglyceride Levels in Indians
R.Lakshmy, H.P.S Sachdev, Meenakshi Sharma, S.K Bhargava,
G.R Chandak and K.S Reddy
269
Abstract No: 10.22: Minerals Status in Thyroid Disorders (Hypo
& Hyper Thyroidism)
B.Suneel, D.R.Nagendra, K.Ramalingam and J.N.Naidu
270
Abstract No: 10.23: Postprandial Hyperglecaemia and Reduction
in Serum Paraoxonase Activity in Type 2 Diabetes Mellitus Subject:
an Alarm of Vascular Complication
Raj Narayan Gupta, Neelima Singh, S.K. Singh and Preeti Dohare
270
Abstract No: 10.24: Anti-oxidant Potential (AOP) of LDL in Post
Menopausal Women Suffering from Type 2 Diabetes Mellitus.
Nivedita Singh, Neelima Singh, Sanjeev Singh and Vishal
Bhargava
271
Abstract No: 10.25: Analysis of Multivariate Factors in Metabolic
Syndrome - a Correlation Study
Vinayak S Bhat, Reshma Kumarchandra and Vijay S.Bhat
271
Abstract No: 10.26: Diabetes Risk Prediction by Fructosamine in
Non diabetic First Degree Relatives
Hegde.A, D’souza.F, Kaveeshwar.V, Jose A, Tasneem.S and
Manjrekar A.P
272
Abstract No: 10.27: A Study of CVD Risk Factors in Metabolic
Syndrome.
Sajimon Thomas and T.Vijayakumar
272
Abstract No: 10.28: CVD Risk Factors in Women with Subclinical
Autoimmune Thyroiditis.
Sudheesh.M and T.Vijayakumar
273
Abstract No: 11.1: Recurrent Aphhous Ulcer and Oral Lichen
Planus: a Study of Patho-physiological and Psychosomatic
Significance of Salivary Nitric Oxide.
AB Agte, Bm Despande, Sm Dharwadkar, Kiran Jagtap,
S.B.Gaikwad and S.R.Holkar
274
Abstract No: 11.2: Oxidative Stress and Calcium Phosphorus Ratio
in Rheumatoid Arthritis
Dr.A.Pullaiah and Dr.N.Vani
275
Abstract No: 11.3: The Role of Oxidative Stress and Fibrinogen
Level in Chronic in Diabetes Mellitus
Mrs. G. Ramani, Dr. Rita Mary Aruna, Dr. T. V. Mohan and
Mrs. G. Kavitha
275
CONTENTS
Abstract No: 11.4: The Effect of Yoga Therapy on Antioxidant
Level in Perimenopausal Women
Alok Kumar, Archana E., Akshatha, Mrs. Gayathry Nayak,
Dr.Revathi P. Shenoy and Dr. Anjali Rao
276
Abstract No: 11.5: Aluminum Induced Morphological and
Biochemical Changes in Liver, Kidney and Brain of Male Albino
Rats; An Age Dependent Study
Anumesh Pathak, Sandeep Tripathi, A. K. Pathak, Abbas Ali Mahdi,
Sanjay Sen, Ramkrishan Ojha and Neelam Dubey
276
Abstract No: 11.6: Reduced Nitric Oxide Synthesis in Preeclampsia: Role of Inflammatory Cytokines and eNOS Gene
Polymorphism
Archana Singh., Deepika Sharma., Chitra Raghunandan and
Jayashree Bhattacharjee.
277
Abstract No: 11.7: Liver Function and Total Antioxidant Capacity
in Hypothyroidism
Bhawna Bhimte, Dr.B.K.Agrawal, Dr.V.K.Sharma and Prashant
Nigam
278
Abstract No: 11.8: A Study on Free Radical Activity in Burns
Dr. Bikash Kr. Chaudhury and Dr. Runi Devi
278
Abstract No: 11.9: Oxidative Stress in N-acetylcysteine Treated
Off Pump CABG Surgery Patient
Shyama Subramaniam, S.Subramaniam, K.Dhanajayan,
K.Ezhilarasan, K.Baskar and B.Jalakandan
279
Abstract No: 11.10: Estimation of Lipid Profile, Vitamin E and
Malondialdehyde, in Pre-eclampsia
Dr. Chandan Kumar Nath and Dr. Upasana Baruah
279
Abstract No: 11.11: Antioxidant Status in Goats During Pregnancy
Cynthia Jose and K.K. Jayavardhanan
280
Abstract No: 11.12: Comparative Study of Lipid Peroxidation
and Non-enzymatic Antioxidant Vitamin E and Vitamin C in
Plasmodium Vivax and Falciparum Malaria in Western Rajasthan
with special reference to Bikaner District.
R.K. Vyas, D. Yadav, M.L. Sharma, Y. Soni and D. Nandini
281
Abstract No: 11.13: Comparative Study of Serum Myeloperoxidase
Level and Lipid Profile in Healthy Individuals
Suchetha Kumari. N and Ramitha K
281
Abstract No: 11.14: Nitric Oxide and Lipid Profile in Type 2
Diabetes Mellitus— A Case Control Study in East Sikkim
Dr. A. Ghosh, Ms. Y. Bhutia, Dr. T. A. Singh and Dr. M. L. Sherpa
282
CONTENTS
Abstract No: 11.15: MDA, Antioxidant Enzymes, their Correlation
in Normotensive and Pre-eclamptic Maternal and Cord Blood
Mohd Suhail, Safia Suhail, Bharat Kumar Gupta and Vinay Bharat
283
Abstract No: 11.16: Superoxide Dismutase Activity in RidleyJopling Leprosy Types
CVB Prasad and MV Kodliwadmath
283
Abstract No: 11.17: Effect of Wheat Grass on Oxidative Stress in
High Fat Diet induced Hyperlipidemia in Rabbits
Dr. Kiran Dahiya, Dr. Veena Singh, Dr. Sangeeta B.Singh, Dr. Jyoti
Sethi, Dr. Mridul Yadav and Mr. Prashanta Saha Roy.
284
Abstract No: 11.18: Study of Lipid Peroxidation and Anti Oxidant
Status in Pre-Eclampsia
Dr. Ranjini.S, Dr. S.S. Halyal and Dr. Jayaprakash Murthy D.S
284
Abstract No: 11.19: Attenuation of Inflammation and Oxidative
Stress by Plumbago capensis in Freund’s Complete AdjuvantInduced Arthritis in Rats
A.I.Charles Dorni , Hannah R. Vasanthi, K.S Jayachandran and
G.V.Rajamanickam
285
Abstract No: 11.20: Effect of Vitamin E Supplement on Blood
Anti-oxidant Status in Cigarette Smokers.
Juhi Aggarwal and Sadhana Sharma
286
Abstract No: 11.21: Oxidative Stress and Antioxidant Therapy in
Nephrotic Syndrome
Jyoti Dwivedi and Dr. Purnima Dey Sarkar
286
Abstract No: 11.22: Antioxidant Status in Patients with
Uncomplicated Type 2 Diabetes Mellitus
K. Sowmya, S.Thanikachalam and Satyajeet Giri
287
Abstract No: 11.23: Chronomics of Oxidants, Anti-oxidant
Enzymes and Related Molecules in Gyenecological Malignancies
R.K Singh, S.Singh, R.Singh, S.Pandey, S.Mehrotra, U.Singh,
O.Schwartzkopff, G. Cornelissen and F.Halberg
287
Abstract No: 11.24: Seminal Malondialdehyde, Nitric Oxide, Zinc
and Superoxide Dismutase Activity in Male Infertility
Kavita More, Prof. P.G Samant and Dr. Z.G Badade
288
Abstract No: 11.25: Study of Nitrate + Nitrite and Antioxidant
Enzyme Levels in Oral Cancer
Kinjal R. Patel, Jayendra B. Patel, Shruti R. Patel, Shilin N. Shukla
and Prabhudas S. Patel
289
CONTENTS
Abstract No: 11.26: Oxidatant and Antioxidant Defence
Mechanism in Chronic Myeloid Leukemia
Rizwan Ahmad, Anil K Tripathi, Payal Tripathi, Vinod Kumar
Singh and Raj K Singh
289
Abstract No: 12.1: Antioxidant Markers and Liver Function
Parameters in Chronic Alcoholics: A Comparative Study between
Koraga Tribal Community, Civilized Alcoholics and Healthy
Controls
Naureen Anwar, Prasiddha Tilak, Mahesh.S and Dr. Mungli Prakash
291
Abstract No: 12.2: Oxidative Stress in Organophosphorous Toxicity
Dr.M.Jaiprakash Babu
291
Abstract No: 12.3: Effect of Lemon Grass Oil Mouthwash on
Patients with Gingivitis
Meghana Bhandarkar, Mahima .B.S, Madhur Agrawal, Sonal
Sukreet, Dr. Shobha.U.Kamath and Dr.Meena Anand
292
Abstract No: 12.4: Oxidative Stress and Vitamin Antioxidant Status
in Rheumatoid Arthritis.
Dr P.B Desai, Dr. Manjunath.S, Dr. Shivraj Gowda, Dr. Sumangala
Kadi, Dr. Shivprasad and Dr. Chetana.K.
292
Abstract No: 12.5: Changes in Advanced Oxidation Protein Product
(AOPP) in Moderate and Severly Uremic Rats
Merin Iype C, Subramanya Upadhya, Sharmila Upadhya and
Gopalakrishna Bhat
293
Abstract No: 12.6: Oxidative Stress and Calcium Levels in Senile
and Diabetic Catract Patients
Deepa K, Sumana Kamath, Vivian D’Souza and Nandini.M
294
Abstract No: 12.7: Oxidative Stress in Erythrocytes and Plasma
of Healthy Controls
Nirjala Laxmi Madhikarmi and Kora Rudraiah Siddalinga Murthy
294
Abstract No: 12.8: Oxidant and Antioxidant status in Metabolic
Syndrome
PVLN Srinivasa Rao, N. Manasa Kumari, Alok Sachan, KVN Raju,
M.M.Suchitra, V. Seshadri Reddy and Aparna R.Bitla
295
Abstract No: 12.9: Study of Antioxidant Enzymes of Seminal
Plasma in Association with Mental Stress Subjects
R.K Padalkar, V.R Pandhare, P.S Kamble and P.D Zande
295
Abstract No: 12.10: Role of Mucuna Pruriens on Antioxidant
Enzymes of Seminal Plasma in Association of Mental Stress
Subjects
VR Pandhare, RK Padalkar, PS Kamble and PD Zende
296
CONTENTS
Abstract No: 12.11: Relationship between ROS and Antioxidants
in Male Infertility
Parineeta Samant, Prof P G Samant and Dr Z G Badade
297
Abstract No: 12.12: Study of Lipid-Peroxidation and Antioxidant
Status in Malaria Patients
Pawan Kare, B.K.Agrawal and V.K.Sharma
297
Abstract No: 12.13: A Study of Oxidative Stress in Cancer Patient
Before and After Supplementation of Vitamin C and E
Dr. Pranami Bordoloi, Dr. Bikash Kr. Chaudhury, Dr. Chandan
Kr. Nath and Dr. Dipali Das
298
Abstract No: 12.14: Biochemical Antioxidative Parameters in Type
2 Diabetic Patients with Cardiovascular Complications.
Prashant Nigam, B. K. Agrawal,V. K. Sharma and Bhawna Bhimte
298
Abstract No: 12.15: Evaluation of Flow Rate, pH, Buffering
Capacity, Calcium, Total Protein and Total Antioxidant Levels of
Saliva in Caries Free and Caries-active Children – an in vivo Study
Dr. Preethi.B.P, Dr. Jayaprakash Murthy.D.S and Dr. Reshma
Dodawad
Abstract No: 12.16: Comparative Study of Free Radical Activity
of Plasmodium Falciparum and Plasmodium Vivax malaria Patients
PS Kamble, RK Padalkar, SR Kharade, PD Zende and VR
Pandhare
Abstract No: 12.17: Alterations in Oxidant and Antioxidant Status
in Early Alcoholic Liver Disease
Ms. Sripradha. R, Dr. M.G. Sridhar and P.Doureradjou
Abstract No: 12.18: Respiratory Burst Enzymes of Leukocytes in
Withaferin Treated Carcinoma of Uterine Cervix
Reshma K, AV Rao, Dinesh M, and Vasudevan D.M
Abstract No: 12.19: Advanced Oxidative Products of Proteins and
Total Antioxidants in Gastric Carcinoma Patients
Anita, Sudha K, Beena V Shetty and Gayatri M Rao
Abstract No: 12.20: Protein Oxidation and Antioxidants in Oral
Cancer
Sudha K, Vinodchandran, Gayathri M Rao and Beena Shetty
Abstract No: 12.21: Oxidative Stress in Maternal and Cord Blood
of Pre Term Infants
Revathi.R, Saravanan.A, Ramakrishnan.T, Bharathy.N and
Sujitha.S
299
300
300
301
301
302
302
CONTENTS
Abstract No: 12.22: Effect of Renoprotective Therapy on Plasma
Thiols and Ferric Reducing Antioxidant Power in Children with
Nephrotic Syndrome
Rimshida Malik, Priya Pai, Dr. Krishnananda Prabhu, Dr. Nalini
Bhaskaranand and Dr. Anjali Rao
303
Abstract No: 12.23: Role of Lipid Peroxidation and Enzymatic
Antioxidant Status in Complicated Pregnancies.
Sadanand.B.Patil, M.V.Kodliwadmath and Sheela M.
Kodliwadmath
303
Abstract No: 12.24: Study of Antioxidant Status with Respect to
AF after Cardiac Surgery
Shalini Nair, Khalid Iqbal, Madhavi S Phadke and Jagdish
Khandeparkar
304
Abstract No: 12.25: Chronic Alcohol Induced Tissue Injury:
Microarray Analyses of Gene Regulation in the Disease Process
R. Sandeep, P.Nagababu, Sunitha T, Rekha.D, Farid.M., Malathi. R
Ranjeetha.N and R.Polavarapu
305
Abstract No: 12.26: Involvement of Cellular Oxidants in
Deregulated Redox Homeostasis in Diabetes Mellitus
P. P. Singh and Farzana Mahdi
305
Abstract No: 13.1: Oxidative Stress and Inflammatory Response
in Pre-eclampsia
Sathish B.M , Bobby.Z and Habeebullah.S
306
Abstract No: 13.2: Antioxidant Activity of Fermented Tea
(Kombucha)
U. Satyanarayana and T. Srihari.
306
Abstract No: 13.3: Health Benefits of Origanum vulgare (a
Medicinal Herb) through its Antioxidant Property.
T. Srihari, U. Satyanarayana and N. Nalini
307
Abstract No: 13.4: Status of Enzymatic and Non-enzymatic Antioxidant Systems in Patients with Acute Ischemic Stroke
J. Sudha Rani
308
Abstract No: 13.5: Oxidative Protein Damage in Thyroid
Dysfunction
Dr. Sweta Shivshanker and Dr. Anushre Prasad
308
Abstract No: 13.6: Auto Antibodies against Oxidized Low Density
Lipoproteins and Lipid Peroxidation in Patients with Essential
Hypertension
K.Ramalingam, K.Santha, S.Sethupathy and R.Vinoth Kumar
309
CONTENTS
Abstract No: 13.7: Oxidative Stress and Insulin Resistance in Type2 Diabetes Mellitus
R.Viswakumar, K.Ramalingam and R.Vinoth Kumar
310
Abstract No: 13.8: Lipid Profile and Glucose Tolerance Test in
Cholelithiasis
R.N. Devaki and H.S Virupaksha
310
Abstract No: 13.9: Association of Hypoalbuminemia with Size of
Pleural Effusion in Pneumonia.
Mrs Ranjita V. Gaur and Dr (Mrs ) Rita M. Shah
311
Abstract No: 13.10: Biochemical Effects of Feeding Diglycerol
Disulphide in Rats Fed Ethanol or High Fat Diet
Blessy M. I., Vinod P., Praveen K. V., Sheeba V., J. K. Mukkadan
and P. K. Joseph
311
Abstract No: 13.11: The Prevalence of Celiac Disease in Patients
Presenting with Gastro-intestinal Symptoms
Satinder Kaur, APS Narang, Navpreet Kaur and Indu Verma
312
Abstract No: 13.12: Jun N-Terminal Kinase (JNK) mediates
Dextran Sodium Sulfate-Induced Tight Junction Barrier
Dysfunction in Caco-2 Cell Monolayers.
Geetha Samak and Radhakrishna Rao
312
Abstract No: 13.13: Storage Stability Characteristics of
Hepatobiliary Enzymes in Cattle and Buffalo
Divya P.D. and K.K. Jayavardhanan
313
Abstract No: 13.14: IL-6 is a Reliable Independent Biochemical
Marker for Predicitng Severity of Acute Pancreatitis
G.Vasanthalakshmi, Pradeep Naik B., Prem Sagar, B. Vijay Kumar
and K.Ravindranath
314
Abstract No: 13.15: Peritoneal Fluid and Bblood Lactic Acid Levels
in Acute Abdominal Disorders
A.P.S. Narang, S Goyal, Indu Verma, Satinder Kaur and
J.S. Multani
314
Abstract No: 13.16: Estimation of Serum Enzymes in Antibiotic
Therapy for Assessment of Hepatotoxicity
Sen S, Sinha S, Nazmi A , Tripathi S and Prashant
315
Abstract No: 14.1: Phytochemical Investigation and Anthelmintic
Activity of Extracts of Seeds of Elletaria cardamomum
A.A Bidkar, M. K. Aswar, K.N. Gujar and C. S. Patel
315
Abstract No: 14.2: Phytochemical Investigation and
Pharmacological Evaluation of Extracts of Leaves of Calotropis
procera Linn.
A.A Bidkar, K.N. Gujar, U.S. Bagul K.S.Kanugo and K.J. Oza
316
CONTENTS
Abstract No: 14.3: Phytochemical Investigations and
Anticonvulsant Activity of Seeds of Brassica campestris.
A. Bidkar, K. N. Gujar, P. S. Parmar, A. A. Deshpande and
A.V. Vaidya
317
Abstract No: 14.4: Anticarcinogenic Effect of Indigofera
Aspalathoides by Influencing Xenobiotic Enzyme Activity During
DMBA Induced Hamster Buccal Pouch Carcinogenesis
Philips Abraham, V. Arul and Dr.S.Sethupathy
317
Abstract No: 14.5: Biochemical Changes of Feeding Nigella sativa
to Rats Fed a High Fat Diet and Treated with Adrenaline
Bini Balakrishnan, Ceema Varghese, Nithi Varghese, Vidya A B,
Praveen K.V, Sheeba Varghese, J. K Mukkadan and P.K Joseph
318
Abstract No: 14.6: Biochemical Changes of Feeding Desmodium
gangeticum to Rats Fed a High Fat Diet and Treated with
Adrenaline
Ceema Varghese, Bini Balakrishnan, Nithi Varghese, Vidya A B,
Praveen K.V, Sheeba Varghese, J.K Mukkadan and P.K Joseph
318
Abstract No: 14.7: Comparative Study of Jamun Powder and Tulsi
Leaf Powder as Hypoglycemic and Hypolipoidemic Agent in
Diabetes Mellitus Type 2
Dr. Meena Verma, Deependra Sharma, Dr. Sangeeta Paneri and
Dr.A.Mishra
319
Abstract No: 14.8: Nyctanthes arbortristis Extract Restores the
Cartilage Damage During Experimental Arthritis
Brijesh Rathore, A .A Mahdi, B.N Paul, P. N Saxena,
Farzana Mahdi and S. K Das
319
Abstract No: 14.9: Polyherbal Anti Diabetic Drug: an Approach
to Cure Diabetes
Gaikwad S.B, Bhagwat V.R and Trivedi D.J
320
Abstract No: 14.10: Extraction and in vitro Evaluation of Biological
Activity of Crude Polyphenolic Extracts from Indian Grapes (Vitis
vinifera) on Transformed (AW13516) and Non-transformed
(HaCaT) Stratified Epithelial Cells.
Neha Tamhankar, Geeta Ibrahim and Milind Vaidya
321
Abstract No: 14.11: Beneficial Effects of Tetrahydrocurcumin and
Chlorogenic Acid on Lipid Profile in Streptozotocin-NicotinamideInduced Diabetic Rats
Karthikesan.K and Pari.L
321
Abstract No: 14.12: Search for a Perfect Diet Including
Antioxidants
Prof (Dr) Kaushal K.Srivastava
322
CONTENTS
Abstract No: 14.13: Antioxidant Evaluation of Some
Hepatoprotective Medicinal Plants
Chorge Ketan, Dr. (Mrs.) Kale K.U and Chorge Ulka
323
Abstract No: 14.14: Does Chilli Affect Platelet Aggregation?
Kiran DK Ahuja, Murray J Adams, Dominic P Geraghty and
Madeleine J.Ball
323
Abstract No: 14.15: Antidiabetic Effects of the Aqueous Extract
of Fruit of Withania Coagulans in Diabetic Albino Rats
Kirtikar Shukla, J.K Gambhir and Rimi Shukla
324
Abstract No: 14.16: A Putative Anticancer Mechanism of Plant
Derived Polyphenols
Mohd. Fahad Ullah, Uzma Shamim, Sarmad Hanif, Asfar S Azmi,
Showket H Bhat and S.M.Hadi
325
Abstract No: 14.17: A Comparative Study of Nitric Oxide and
Hydrogen Peroxide Scavenging Activities of Botanical Extracts
Ocimum sanctum and Wagatea spicata.
Geetha Samak, Revathi P Shenoy and D. M. Vasudevan
325
Abstract No: 14.18: Cardioprotective Effect of Terminalia arjuna
on Isoproterenol Induced Myocardial Infarction in Rats
S.K. Shukla, S. Dwivedi, U.R. Singh, and S.B. Sharma
326
Abstract No: 14.19: Aluminum Induced Changes in Blood and
Brain; Protective Role of Bacopa monnieri
Sandeep Tripathi, Abbas Ali Mahdi, Mahdi Hasan, Deepa Prajapati,
Sanjay Annarao, Raja Roy and C. L. Khetrapal
327
Abstract No: 14.20: Hypolipidemic Activity of Hibiscus rosa
sinensis (root) in Hyperlipidemic Rats
Vishnu Kumar , Ranjana Singh , Sushma Singh , Shivani Pandey ,
Ashok Kumar Khanna , Ramesh Chander ,Pradyumn Singh,
Farzana Mahdi , Jitendra Kumar Saxena , Vinod Kumar Singh
and Raj Kumar Singh
327
Abstract No: 14.21: Cholinesterase Activity in Health Workers
Involved in Handling and Spraying of Organophosphorous
Insecticides
Himanshu Madaan, Veena Singh Ghalaut and Ashuma Sachdeva
328
Abstract No: 14.22: Lead Poisoning in Residential Areas Near
Drainage Systems in Bangalore
Anitha Jerry Juneeja Varghese and Antony.P.U
329
Abstract No: 14.23: Study of ADA Levels in Tuberculus and Non
tuberculus Pleural Effusion
K. Sravanthi, Dr. B. Prabhakar Rao, Dr. V. Sunanda and
Dr. C.N. Prasad
329
CONTENTS
Abstract No: 14.24: A Brief Study of Lead Poisoning Among
Children
Faculty and Students
330
Abstract No.14.25: Iodine Deficiency Disorders Among the
Primary School Children of Eastern Nepal.
Gelal.B, Chaudhari.R, Nepal.A, Das B.K.L, Lamsal.M and
Baral.N
330
Abstract No.14.26: Role of Plasma Homocysteine Level in
Coronary Artery Disease and Stroke- A Clinical Perspective
Girish P. Pandey, Sukhes Mukherjee, Kannan Vaidyanathan and
D.M Vasudevan
331
Abstract No.14.27: Vitamin B12 and Folic Acid Levels in Tobacco
Chewers: A Duration Dependent Study.
Indira Samal, M.Maneesh, Sukhes Mukherjee and Subir K Das .
331
Abstract No.14.28: Role of Pro and Anti-inflammatory Cytokines
in the Modulation of alcoholic Liver Disease.
Sukhes Mukherjee, Subir Kumar Das, and D.M Vasudevan
332
Abstract No.14.29: Urine glucose estimation
Imbichi Mammi
332
Abstract No.15.1: Antidiabetic Activity of a Coastal Mangrove,
Rhizophora mucronata Poir. : Effect on Carbohydrate Metabolism
in Alloxan-induced Diabetic Rats
K. Desigamani b , S. Manivannan * , K Kathiresan a and T.
Ramanathana rita mary arunab
333
Abstract No.15.2: Antitumour Activity of Some Homoeopathic
Medicines in Animal Models and Possible Mechanism of Action
Ramadasan Kuttan, Preethi K.C., Girija Kuttan
333
Abstract No.15.3: Radioprotective and Chemoprotective Effect of
Carotenoid Meso-zeaxanthin
A.P. Firdous and R. Kuttan
334
Abstract No.15.4
Hepatoprotective Activity of Carotenoid Lutein
Sindhu E R and Ramadasan Kuttan
335
Abstract No. 15.5: XRCC – 1 Polymorphisms (Arg194Trp and
Arg399Gln) in Oral Cancer from a Kerala Population.
Balaji Natarajan
335
Abstract No.15.6: Multiple Myeloma, 2008 Statistics
Ramesh K, Riju M, Prasanth G, Sreejith A.S.,
336
CONTENTS
Abstract No. 15.7: Auto Immune Thyroid Disease Antibodies
Riju M, Prasanth G, Sreejith A S. Ramesh K,
336
Abstract No.15.8: Orocecal Transit Time and Small Intestinal
Bacterial Overgrowth in Patients with Microscopic Colitis
SV Rana, KK Prasad, SK Sinha, S Sharma, J Kaur and K Singh.
337
Abstract No.15.9: Plasma Myeloperoxidase in Diabetes Mellitus
Usha Anand, Vijaya D, Gayathri B, Aruna V and Anand CV
338
Abstract No.15.10: Serum Cystatin C in Various Stages of Chronic
Kidney Disease
Krishnamurthy N 1, Usha Anand 2, Anand C.V 2, Aruna V 2 and
Venu G 3
338
Abstract No.15.11: Evaluation of Hyperglycemia, Glucose
Intolerance, Hypertension and Socioeconomic Position in Eastern
Nepal
Mehta KD1, Karki P2, Lamsal M1, Paudel IS3, Majhi S1, Das BKL1
Sharma S2 Jha N3 and *Baral N1
339
Abstract No. 15.12: Advanced Research on Heavy Metal Pollution
in Ganga Water; Detection with Integrated Coupled Plasma-Atomic
Emission Spectrometry
Ashutosh Kumar Sharma
340
Abstract No.15.13: My Experience of Two Decades Using Mid
Size Laboratory Automation in Clinical Laboratory Practice
Dr. Ulhas R. Tendulkar, Director, Ambalab, Goregaon East,
Mumbai-400063
340
Abstract No. 15.14: Detection of Mitochondrial Point Mutation in
Maternal Inherited Diabetes with Deafness (MIDD) Using Various
Molecular Tools
R.R. Kumar, K. Ponsuganthi, S. Selvaraj*, H. Palaniswamy#, B.
Mohanty
341
Abstract No. 15.15: Gold in Human Semen Around and Away from
a Gold Deposit Area
Sahab Khan P, Skandhan K Pa, Ajesh K, Siraj MVP.
342
Abstract No. 15.16:
Effect of Chilli (Capsaicin)on Oxidation of Serum Lipoproteins
Kiran D.K Ahuja and Madeleine J. Ball
342
Indian Journal of Clinical Biochemistry Supplement, 2009/24
ORATIONS
O-1.
Dr.T.N Pattabhiraman Oration-Laboratory Overload: How to Optimize?
Brig MM Arora
Professor & Head, Dept of Biochemistry, Armed Forces Medical College, Pune-411040. Email:
[email protected]; Lt. Col. (Mrs) J.k Bhatia, MD, Classified specialist pathology, Military
Hospital, Dehradun (UP)
Background: Medical fraternity requisitions
diagnostic tests for multiple reasons. More often
than not, the tests lead to more tests either to
exclude or to confirm doubts raised by the test
results. These tests do have inherent morbidity,
discomfort and cost. Growing expenditure on
diagnostic tests without matching improvement
in the health status warrants an internal audit of
the laboratory utilization.
Methods: A retrospective utility audit was done
for certain routinely advised laboratory tests. Tests
included in audit were blood urea estimation in
annual as well as periodic medical examination;
bleeding and coagulation time in pre-anesthetic
check-up; and aspartate aminotransferase (AST);
antibodies to hepatitis C virus (anti-HCV) in
diagnostic work-up of acute onset jaundice; and
T3, T4, TSH estimation in evaluation of thyroid
function.
acute onset jaundice, 6049 AST estimations in
1024 patients did not contribute anything more
than what was inferred by alanine aminotransferase
(ALT). Prevalence of anti HCV antibodies in acute
onset jaundice in serving soldiers (11 out of 1225;
0.89%) though more than that in the blood donors
from the same population (17 out of 4105; 0.41%)
was less than anticipated false positives (18 out of
1225; 1.5%) as per the claimed specificity (98.5%)
of the test kit. None of the 2766 bleeding and
clotting time tests detected a bleeding or
coagulation disorder. Despite sizable evidence in
favour of TSH being an adequate single screening
test for evaluation of thyroid, the ordering
frequency of T3, T4, and TSH was nearly the same.
Conclusion: The study reveals gross overuse of
the laboratory that may not be good for the patient
and the organization in terms of direct costs as well
as indirect costs due to false positive results. To
make the matters worse, this laboratory overload
Results: During the period of study, 793 adversely affects the quality and availability of
individuals underwent AME / PME. In none of laboratory results. Therefore, a test should only
them urea estimation provided any additional be advised, if positive or negative result would
information which was not inferred by serum
dictate a change in patient management.
creatinine. Similarly, in diagnostic workup of
O-2.
K.E.M. Hospital and Seth G.S. Medical College Oration
Regenerative Nanomedicine - Prospects for Diagnostics and Therapy using
Nanomaterials
Shanti Kumar Nair
Dean of Research, Head of Nanotechnology Division, Amrita Institute of Medical Colllege, Kochi.
Nanotechnology has shown great potential as a for augmenting the body’s healing capacities in
primary diagnostic and therapeutic tool in the the area of regenerative medicine through novel
medical sciences. It has also shown its potential approaches such as tissue or organ engineering.
46
Indian Journal of Clinical Biochemistry Supplement, 2009/24
The diagnostic potential of nanotechnology has
been advanced by the development of novel
nanoparticles with luminescence or
superparamagnetic or scintillator properties. Such
nanoparticles can be tagged to diseased tissues,
such as cancer cells and detected by their relevant
scale-modulated property.
Tagging of
nanoparticles to cells has emerged as a new science
involving interaction of chemical moieties with
the nanoparticle surface and with the cell
membrane or with monoclonal antibodies.
Successful tagging of nanoparticles has opened
the door to cell-specific rather than systemic
therapy. In cell-specific therapy the drugs are
delivered specifically to the target cells by
conjugating the drugs with the nanoparticles or
encapsulating the drugs within nanoparticles.
Other therapeutic approaches involve
photodynamic or thermal therapies which do not
involve highly toxic chemotherapeutic agents. In
regenerative medicine also nanotechnology has
shown the potential to enhance the regenerative
ability by its ability to control cell-material
interactions. The control of cell-material
interactions using nanomaterials has emerged as
a new and dynamic science with great potential
for healing and regeneration of tissues and organs.
In this presentation the author will present some
of the data from his own lab as well as some data
from other leading scientists in the area.
O-3.
Mrs. & Dr.G.P Talwar Oration
Endothelial Dysfunction with Special Reference to eNOS Gene Polymorphism:
Another Plausible Mechanism for CAD Risk in Postmenopausal Women
Jayashree Bhattacharjee
Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
Background: Framingham study indicates more
than two fold age related increased risk of
Coronary artery disease (CAD) in postmenopausal
women as compared to premenopausal women.
Nitric Oxide (NO) is an important regulator of
endothelial functions and has several cardio
protective actions as vasodilation, inhibition of
platelet aggregation & adhesion. The Glu298Asp
polymorphism of endothelial nitric oxide synthase
gene (eNOS) is associated with CAD risk.
Estrogen exerts its local vasodilating and
antiplatelet actions as a consequence of endothelial
response mediated by release of EDRF (endothelial
dependent relaxing factor), which is NO.
other established CAD risk markers for the purpose
of early diagnosis and intervention.
The purpose of this study was to assess CAD risk
in postmenopausal women by evaluating Nitric
oxide – Cyclic GMP signal transduction pathway
& screening Glu298Asp polymorphism along with
Results: Plasma NO, Estrogen and HDL levels
was found to be significantly lower (P<0.05) while
VLDL and Apo-B levels shown significant
increase (p<0.05) in postmenopausal women cases
Methods: Two consecutive studies were
conducted. Each study design consists of 50
postmenopausal women cases compared with 50
premenopausal women controls for similar age
group excluded for any known CAD risk. In the
first study we measured the levels of NO, Estrogen,
Apo-B and functional relation of NO and cGMP
to evaluate signal transduction pathway. The
second study was done to investigate the associated
role of Glu-Asp298 eNOS gene polymorphism &
platelet function in increasing postmenopausal
CAD risk.
47
Indian Journal of Clinical Biochemistry Supplement, 2009/24
as compared to Premenopausal women controls.
Plasma cGMP levels were significantly lower
(P<0.05) in cases than controls. A significant
positive correlation was observed between NO and
estrogen (P<0.01) whereas negative correlation
was found between NO and PF4 (P<0.01).
The GG genotype was found in 41 subjects (82%)
of the study group and 45 subjects (90%) of the
control group while GT genotype was seen in 9
subjects (18%) of study group and 5 subjects
(10%) of control group. No TT genotype was
found. The significant decrease was observed in
NO levels of GG+GT, GG and GT genotypes of
study group as compared to control group.
Conclusion: the low no and low cgmp activity
found in our study reflects defect in no-cgmp signal
transduction which leads to endothelial
dysfunction. as cad is a multifactorial disease, other
factors might also play a major role in endothelial
dysfunction to increase cad risk in postmenopausal
women. observations found in our study suggest
that enos glu298asp gene polymorphism and nitric
oxide levels may be associated with an increased
risk of coronary artery disease in postmenopausal
women. further studies are needed to explore more
mechanistic basis of the association which in turn
will modify therapeutic and diagnostic strategies.
O-4.
K.L Gupta Memorial Oration
Tyrosine Kinases from Basic Science to Therapy
T.S.Ganesan
Chairman, Cancer Institute & Institute of Molecular Medicine,Amrita Institute of Medical Sciences,
AIMS P.O. Kochi, Kerala, 682 041
Protein phosphorylation is a central event in cellular physiology. Phosphorylation on tyrosine residues by tyrosine kinases is particularly important
as it is subverted in malignant transformation. This
is apparent with the discovery of a number of
oncogenes which are tyrosine kinases. It is now
clear the number of families of tyrosine kinases
in the human genome and is restricted to meta-
zoans. Research into the role of tyrosine kinases
in malignant transformation has uncovered many
new targets for treatment. The first such kinase is
the ‘abl’ kinase, but more kinases are now
druggable. This whole area of research represents
an excellent examples of how basic research has
led to discovery of new treatments for cancer.
O-5.
Awadesh Saran Memorial Oration
Lead Poisoning: Current Status in Developing Countries and the Global Perspective.
Thuppil Venkatesh
Professor Emeritus. St John’s Medical College Bangalore and Principal Advisor Quality Council of
India, Delhi.
Lead being one of the toxic heavy metals globally considered as the number one environmental and
48
Indian Journal of Clinical Biochemistry Supplement, 2009/24
health hazard affecting people of all age groups
has maximum effect during growth and
development of children. With its deleterious
effects on all organs in the human body, lead
poisoning is widely recognized as a major public
health problem all over the world. Children and
women are found most vulnerable to lead
poisoning especially in developing countries.
Unlike other health hazards, lead poisoning is
hundred per cent preventable when legislation is
in place.
The estimate by the World Health Organization
has indicated that over 120 million people are
overexposed to lead all over the world and 99
percent of the most serious cases are in the
developing world. The project Lead Free of The
George Foundation was initiated in Bangalore and
its vicinity, and subsequently expanded to several
other major cities across India), found that more
than 51.3 per cent of children in Indian metros
below 12 years of age have their blood lead levels
above 10 ug/dl. Blood lead levels above 10ug/dl
is known to reduce the IQ during growth and
developmental phase of children. An average
reduction of IQ to an extent of 4-6 units on a scale
is known to result in the economic damage to
countries to the tune of over Rs 600 crore annually
by 2015.
Author was involved in the introduction of
unleaded gasoline in India in March 2000, and has
recently found out other major sources such as
lead based traditional medicines and lead-based
paints. Detailed studies by the author has indicated
that though the per capita consumption of paints
in India is around one-fifteenth of developed
countries with a demand as on date with the
unprecedented boom in the housing sector which
is expected to satisfy the demand for over 30
million new homes which is a great threat to the
countries future economy. A study report by the
author during 2006 on the analysis of lead in paints
in China, India and Malaysia revealed that over
80 new paints from these countries used in homes
had very high lead levels — in fact, exceeding the
levels of 1000 ppm. Though there is a need for
the ban of lead-based paints all over the world,
which has been emphasized time and again to
prevent exposure and associated sicknesses,
developing countries have not taken this seriously.
In India, for example, lead-based paints were found
in the homes of three children whose blood lead
levels were at least 40 ug/dl. In a report on dust
lead levels in Delhi, homes had dust with lead
levels of 31 per cent. That incidentally exceeds
the current US limit of 40 ug/sq ft.
Apart from this almost 80% of all the lead now
used in many parts of the world is for the
production of lead-acid batteries and that in India
and other developing countries the environmental
friendly recycled lead is of much lower proportion
in lead acid battery manufacturing causing another
major threat to both environment and health.
Author is involved in the development of the BEST
certification program to all lead acid battery
industry in the country with wide acceptability.
With the recent efforts to create lead map of two
megacities in India the National Referral Center
for Lead Poisoning in India established by the
author with several branches all over the country
is conducting lead educator program sponsored by
QCI is working towards lead safe society.
49
Indian Journal of Clinical Biochemistry Supplement, 2009/24
KEY NOTE ADDRESSES
KN-1.
Vitamin E is activated by phosphorylation to ?-tocopheryl phosphate
Angelo Azzi
Vascular Biology Laboratory, JM USDA-HNRCA at Tufts University, Boston, MA 02111, USA.
Vitamin E (α-Tocopherol), traditionally described
as an antioxidant, has revealed to posses specific
cellular functions that are independent of its radical scavenging properties. It inhibits protein kinase C and PI3 Kinase, as well as activates protein phosphatase 2A and diacylglycerol kinase.
α−
α−Tocopherol
Kinase
Phosphatase
α−
α−Tocopheryl phosphate
α−
α−Tocopheryl phosphate receptor
the effects caused by á-TP to cells, in a dose-dependent way. In a search for genes that are specifically and strongly affected by αTP, gene arrays representing essentially all human genes were
used. A group of genes was found that is up-regulated by αTP but not by αT; suggesting that in some
cells αT is not sufficiently converted to αTP. Genes
which were regulated by both compound were
more affected by αTP than by αT.
References
1. Azzi, A. (2007) Molecular mechanism of alphatocopherol action, Free Radic Biol Med. 43, 1621.
2. Gianello, R., Libinaki, R., Azzi, A., Gavin, P.
D., Negis, Y., Zingg, J. M., Holt, P., Keah, H.
H., Griffey, A., Smallridge, A., West, S. M. &
Ogru, E. (2005) Alpha-tocopheryl phosphate:
a novel, natural form of vitamin E, Free Radic
Biol Med. 39, 970-6.
SIGNALING
GENE EXPRESSON
3. Negis, Y., Zingg, J.-M., Ogru, E., Gianello, R.,
CELL MODULATION
Libinaki, R. & Azzi, A. (2005) On the Existence
of Cellular Tocopheryl Phosphate, its Synthesis,
Furthermore, at transcriptional level, several genes
Degradation and Cellular Roles: A Hypothesis
(the first to be described have been CD36,αTTP,α-tropomyosin, and collagenase) are moduIUBMB Life. 57, 23 - 25.
lated by α-tocopherol [1]. α-Tocopheryl phosphate
(á-TP) is synthesized and hydrolyzed in animal 4. Munteanu, A., Zingg, J.-M., Negis, Y., Azzi, A.,
Ogru, E., West, S., Libinaki, R. & Gianello, R.
cells and tissues; it modulates also several cell
(2004) Modulation of cell proliferation and gene
functions [2, 3]. While it is similar to á-tocopherol
expression by ?-tocopheryl phosphates:
(á-T), á-TP appears to be more potent than á-T in
Relevance to atherosclerosis and inflammation,
inhibiting cell proliferation, down regulating
Biochemical and Biophysical Research
CD36 transcription, inhibiting atherosclerotic
Communications. 318, 311-316.
plaque formation etc. In cells and animals á-TP
does not act by liberating á -T; rather, the
intactmolecule appears to be more potent than á- 5. Negis, Y., Aytan, N., Ozer, N., Ogru, E.,
Libinaki, R., Gianello, R., Azzi, A. & Zingg, J.
T itself [4, 5]). á-TP can be defined as the active
M. (2006) The effect of tocopheryl phosphates
form of á-T. Administration of á-TP to cells or to
on atherosclerosis progression in rabbits fed
animals requires its transfer through membranes.
with a high cholesterol diet, Arch Biochem
Specific inhibitors, glybenclamide and probenecid
Biophys. 450, 63-6.
showed to inhibit á-TP transport and to eliminate
50
Indian Journal of Clinical Biochemistry Supplement, 2009/24
KN-2.
Impact of Pharmacogenetics on Therapeutic Drug Monitoring
M. Oellerich, V.W. Armstrong and N.Von Ahsen
Department of Clinical Chemistry, George-August-University Göttingen, Germany
Pharmacogenetics and its application to TDM is
an emerging field. Gene test guided therapy could
facilitate the selection of a drug and its dosage to
which the patient best responds. A future goal may
be a pharmacogenetic patient card. Valid
pharmacogenomic biomarkers listed by the FDA
include drug metabolising enzymes (CYP2C9+,
CYP2C19, CYP2D6, DPD, NAT, TPMT + ,
UGT1A1 + ) as well as HLA-B*5701 + and
VKORC1+. Genomic biomarkers for which testing is recommended are marked (+). There is a lack
of evidence supporting a clear association between
ABCB 1 (MDR1) genotype and clinical drug response or toxicity. Variability of P-glycoprotein
expression can affect intralymphocyte concentrations of cyclosporine. It could be demonstrated
that the intracellular T-lymphocyte cyclosporine
concentration has a potential for predicting rejection. The CYP2D6 polymorphism plays an important role in the metabolism of antipsychotic as
well as antidepressant drugs and tamoxifen. Due
to multiple copies of a functional allele in
ultrarapid metabolisers, a standard dose of antipsychotic or antidepressant drugs leads to low
plasma concentrations and a lack of therapeutic
effect. Ultrarapid metabolisers are predominantly
found in Saudi Arabia and Ethiopia (allele frequency 10 – 29 %) and according to our own investigations in Papua New Guinea populations (12
%). Tamoxifen is used for the treatment of patients
with hormone-dependent breast cancer. It is converted by CYP3A and CYP2D6 to active metabolites which are more potent than the parent drug.
Time to disease progression was significantly
shorter in Asian patients treated with tamoxifen
who were poor metabolisers (CYP2D6*10/*10),
compared with other genotypes evaluated.
CYP2D6 genotyping may help to identify breast
cancer patients who will benefit from tamoxifen.
Thiopurine-S-methyltransferase (TPMT) deficiency causes azathioprine intolerance accompanied with severe myelosuppression. Testing for
TPMT phenotype/genotype is a useful practice for
a safer management of patients requiring
thiopurine drugs. An inosine triphosphatase mutation (ITPA 94C>A) appears to be a further promising marker for azathioprine interolerance. A polymorphism in the CYP3A5 gene leads to deficiency
of the enzyme and may in part contribute to
interindividual differences in CYP3A dependent
drug clearance. Recent investigations have shown
a significant difference in dose-adjusted tacrolimus
blood levels between CYP3A5 expressors compared to non-expressors. HLA-B*5701 genotyping
is useful to identify patients at greatest risk for a
hypersensitivity reaction to abacavir. Genomewide assessments of gene expression are increasingly being used and, e.g., have identified
SLCO1B1 variants that are strongly associated
with statin-induced myopathy. Expression profiling has the potential to identify gene-expression
patterns related to drug response. Both approaches
may be complementary and take into account that
the response to most drugs is influenced by multiple genes. Drug disposition marker genotyping
is a promising tool in addition to TDM for
individualisation of drug dosing with the goal to
improve the efficacy and safety of pharmacotherapy.
51
Indian Journal of Clinical Biochemistry Supplement, 2009/24
INVITED LECTURES
IL-1.
The role of Bone Turnover Markers in Clinical Management of Osteoporosis
SD Vasikaran
Royal Perth Hospital, Perth, Australia
The diagnosis of osteoporosis is based on bone
mineral density measurement (BMD). The
decision to treat is better assisted by the calculation
of absolute fracture risk, which incorporates age
and clinical risk factors in addition to BMD.
Current algorithms for the calculation of fracture
risk do not incorporate bone turnover markers
since there are inadequate data for their use in risk
calculation. In clinical practice bone turnover
markers may help make cost effective treatment
decisions in patients with borderline absolute risk.
Bone turnover markers which show an early
response following commencement of treatment
are useful for the monitoring of therapy for
osteoporosis for which the use of BMD is
increasingly being questioned. The use of bone
turnover markers helps to identify non-compliance
and non responders early. In addition to the above
issues, this talk will address individual bone
turnover markers which are of most value in
clinical practice.
IL-2.
A New Diagnostic Paradigm: Some Enabling Technologies
Ross Barnard
School of Chemistry and Molecular Biosciences, The University of Queensland,
St.Lucia Qld, Australia
The traditional approach to diagnosis is one that
has been practised since the time of hippocrates.
It entails forming an hypothesis (a presumptive
diagnosis) followed by design of specific tests to
refute or confirm the presumptive diagnosis.
Until recently this has been the basis for design
of molecular tests for microrganisms, including
viruses. A persistent problem is differential
diagnosis, when presentation is similar for a
range of possible infectious agents (for example,
a wide range of arboviruses; H5N1 (“avian”)
versus H1N1 (“swine”) or H3N8 (“equine”)
influenza). There are several forces operating to
move us away from this model towards a “one
test model. These are: 1) a need to quickly detect
52
unknown, unanticipated or emerging pathogens, 2)
the pressing need to rapidly acquire more
clinically useful information about pathogens (for
example drug resistance, host preference and
pathogenicity “signatures” in influenza a, 3)
multiplexing, that is, performance of many tests
simultaneously and 4) the need for point-of-care
or field testing. These forces are driving
innovation in molecular methods, bioinformatics
and devices. Some examples of these innovations
will be given from our work on flavivirus testing,
influenza a testing, virus drug resistance testing
and a new, multiplexable, real time pcr
technology.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-3.
The Natural Phenolic, Malabaricone B Selectively Kills the Cancer Cells through
Mitochondrial Pathway
S. Chattopadhyay
Bio-Organic Division, Bhabha Atomic Research Centre, Mumbai – 400085, India.
Redox dysregulation originating from metabolic
alterations and dependence on mitogenic and survival signaling through reactive oxygen species
represents a specific vulnerability of malignant
cells that can be selectively targeted by redox chemotherapeutics. Simultaneous modulation of multiple redox sensitive targets by these agents can
overcome cancer cell drug resistance, a common
impediment of anti-cancer drug development.
Search for suitable experimental chemotherapeutics that induce positive deviations from redox homeostasis through prooxidant action has therefore
drawn much attention. A wide array of natural phenolics, such as turmeric, epigallocatechin gallate,
resveratrol, as well several established drugs such
as bleomycin, cisplatin, etoposide and paclitaxel
exert their anti-cancer action through the
prooxidant mechanism. The diarylnonanoid,
malabaricone B, isolated from the Indian spice,
Myristica malabarica was found to possess
chemopreventive property against A549 (human
lung carcinoma), A375 (human malignant melanoma), and Jurkat (human T cell leukemia) especially the A549 cells. It caused apoptotic killing
of the A549 cells via activation of caspase-9 and
caspase-3, but not caspase-8 by altering the BaX/
Bcl-2 ratio. This revealed the mechanism of its
action was primarily linked to mitochondrial damage, inducing the release of cytochrome c into the
cytosol and apoptosome complex formation. The
mal B-induced mitochondrial depolarization, subsequent cytochrome c release and cell cycle arrest
were also confirmed with the A549 cells. Interestingly, the cytotoxicity of the phenol proceeded in
a p53-independent manner, as revealed from our
results with stably transfected A549- p53 cells.
Mutation of the tumor suppressor protein p53,
which serves as a pivotal component of the
apoptosis pathway(s) is believed to be an important factor in poor prognosis of cancer and plays a
critical role in the resistance of cancers to radiation and chemotherapy. Also, compared to the
DNA targeting compounds, chemotherapies,
aimed at mitochondrial inhibition can selectively
kill tumour cells. In view of these, and our results
with malabaricone B on the A549 cells suggested
it to be a promising anti-cancer agent for further
evaluation
IL-4.
Marine Brown Algae with Potent Antioxidant and Radical Scavenging Activities
1
M.S.Kanthimathi, 1Ghaitri Nadarajan and 2Khoo Kong Soo
1
Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur,
Malaysia, 2 Department of Bioscience and Chemistry, Faculty of Engineering and Science, Tunku
Abdul Rahman University, 53300, Setapak, Kuala Lumpur, Malaysia. [email protected]
The ocean has always been a rich source of food
and medicines for humans. Fairly recently, researchers have turned to the sea for alternative
sources of medicinal drugs and supplements for
health and wellness. However, procedures for the
extraction of bioactive components from marine
organisms vary from researcher to researcher. We
tested the efficiency of various popular protocols
used in different labs and estimated various antioxidant and free radical scavenging activities as
53
Indian Journal of Clinical Biochemistry Supplement, 2009/24
markers for efficient extraction of antioxidants
from 2 species of brown algae, Padina
tetrastromatica and Turbinaria ornata. The best
protocol was 72 hours sequential extraction at
room temperature with hexane, followed by
dichloromethane, acetone, ethyl acetate and
methanol. The activities estimated were the FRAP
value, scavenging activities for the DPPH radical,
the superoxide anion, and the hydoxyl ion, total
phenolic content as well as the antiproliferative
activity towards two breast cancer cell lines.
IL-5.
Male Infertility: Role of Oxidative Stress and Some Possible Herbal Remedies
Abbas Ali Mahdi, Mohd. Kaleem Ahmad, Kamla Kant Shukla,
Singh Rajender**, Satya Narain Shakhwar* and Sohail Ahmad***
Departments of Biochemistry and *Urology, C.S.M. Medical University, Lucknow-226003, **Central
Drug Research Institute, Lucknow-226001, ***State Government T.T. College (Unani Medical
College), Lucknow-226003.
Infertility may be defined as failure to conceive
by a couple after 12 months of unprotected sexual
intercourse. Infertility affects 15% of all couples
and approximately 50% of these have an
abnormality detectable in the male partner as the
cause of infertility. Specific and directed treatment
for male infertility is not available due to
unexplained and heterogeneous nature of the
disorders. Under such circumstances, only assisted
reproductive techniques are of some help.
However, these treatments are expensive and
inaccessible to all. The lack of available specific
therapies for men with infertility demands the
exploration of alternative therapies. Given the lack
of knowledge about etiological factors, a nondirected but general therapy may yield good
results in a subcategory of patients. The rationale
for the use of these therapies is based on the
speculation that some forms of male infertility are
caused by oxidative insult and hormonal
imbalance and the use of alternative therapies may
improve male fertility potential and semen quality.
Ayurveda and Unani systems of medicine have
documented several Indian herbs which have been
in use for treatment of various disorders of male
reproductive system. Many scientific studies have
documented the beneficial effect of treatment of
infertile men with these plants, supporting the
54
literature regarding their medicinal usage. After
an in depth search of literature, we came across
more than 25 plants, the parts of which had been
used in male infertility treatment. On the basis of
information available, we made a priority list of
the plants for scientific studies. We conducted
studies in infertile men using seeds of Mucuna
pruriens and root powder of Withania somnifera.
Both these plants were highly beneficial in treating
male infertility. The plants were particularly helpful
in alleviating oxidative stress, which may be one
of the reasons for their beneficial effect. W.
somnifera had better anti-oxidant properties than
M. pruriens. We also conducted experiments on
normal and fertility compromised rats using these
plant products. We could replicate the results in
rats as far as improvement in spermatogenesis is
concerned. The current status of scientific studies
on fertility enhancing plants and the results from
our own studies on male infertility treatment will
be discussed in detail during the presentation.
References:
1. Shukla, K.K., Mahdi, A.A., Ahmad, M.K.,
Shankhwar, S.N., Jaiswar, S.P., Tewari, S.C.,
(2007) Effect of Mucuna pruriens on stress
associated biochemical changes in seminal
Indian Journal of Clinical Biochemistry Supplement, 2009/24
plasma of infertile males. e-CAM. (Available
on line December 18, 2007)
axis. Fertility and Sterility. Available online from
October 28, 2008.
2. Ahmad, M.K., Mahdi, A.A., Shukla, K.K.,
Jaiswar, S.P., Ahmad, S. & Islam, N. (2008)
Effect of Mucuna pruriens on semen profile and
biochemical parameters in seminal plasma of
infertile men. Fertility and Sterility. 90(3) : 627635.
5. Mahdi, A.A., Shukla, K.K., Ahmad, M.K.,
Shankhwar, S.N., Jaiswar, S.P. and Chander. R.
(2009) Withania sominifera reduces stress and
improves the quality of semen in
normozoospermic infertile men. e-CAM [In
press].
3. Shukla, K.K., Mahdi, A.A., Shankhwar, S.N.
and Ahmad, M.K. (2008) Effect of Mucuna
pruriens on hormonal status and semen quality
in infertile males. Contraception. Vol. 78 (2):
194.
6. Ahmad, M.K., Mahdi, A.A., Shukla, K.K.,
Islam, N., Singh R., Madhukar, D., Shankhwar,
S.N. and Ahmad, S. (2009) Withania somnifera
improves semen quality by regulating
reproductive hormone levels and oxidative
stress in seminal plasma of infertile males.
Fertility and Sterility (F and S6491R1) [In
press].
4. Hukla, K.K., Mahdi, A.A., Ahmad, M.K.,
Shankhwar, S.N., Singh R, Jaiswar, S.P. (2008)
Mucuna pruriens improves male factor fertility
by its action on hypothalamus-pituitary-gonadal
IL-6.
[(E)-HST-1], 3’-5’ Hydroxylated Congener of Resveratrol, A Better Anticancer Agent
Sandip K Bandyopadhyay
Department of Biochemistry, Institute of Post Graduate Medical Education & Research KPC Medical
College & Hospital, Kolkata.
Resveratrol is potentially of interest for the treatment of different cancer but its use was constrained
because of its ulcerogenic adversative effects. We
have already reported that 3‘ -5 hydroxylated congener [(E)-HST-1] of Resveratrol was devoid of
ulcerogenic properties; hence in this study we
compared its chemopreventive potential with
Resveratrol in different cancer cell lines and analyzed the probable molecular mechanism of its
action. Our results revealed that HST-1 could exert better antiproliferative effects on different cancer cell lines compared to Resveratrol but showed
least toxicity to normal cells. HST-1 treatment
induced apoptotic cell death as evident from
externalization of phosphatidylserine, DNA fragmentation and cell cycle arrest at G0/G1 phase. In
our pursuit to dissect molecular mechanism the
cells were treated with caspase inhibitor which
confirmed the involvement of caspase-3 and
caspase-9 in HST-1 treated apoptosis.To confirm
the activation of mitochondrial death signal, the
change in membrane potential was analyzed in
HST-1 treated cells which was further substantiated by the release of cytochrome c in cytosol
from mitochondria. Our intricate investigation revealed that HST-1 treatment elicited intracellular
ROS generation and pretreatment of intracellular
ROS scavenger NAC gave significant protection
to the cells treated with HST-1 . NAC treatment
prevented the loss of mitochondrial membrane
potential and also reduced the cytochrome c releases followed by inhibition of caspase activation in HST-1 treated cells. These observations thus
confirmed that HST-1 a potentially better congener of Resveratrol exerted chemopreventive effects
through mitochondrial death cascade which is
modulated mainly by generation.
55
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-7.
Oxidative Stress Management: Therapeutic Approach for Depression
Naheed Banu, Ayesha Zafir, Shoa Naqvi and Ghazala Mehdi *,
Department of Biochemistry, Faculty of Life Sciences,*Department of Pathology,
J. N. Medical College, A.M. University, Aligarh, U.P., India, [email protected]
Objective: Anomalies in oxidative biology are
now recognized as a critical pathophysiological
mechanism for stress and depression. Biochemical
evidence that depressive behaviour is indeed
associated with deficits in the protective
antioxidant system is still lacking. Recently we
showed that augmentation of in vivo antioxidant
defenses might provide a convergence point for
the neuroprotective effects of different
antidepressants used for treating stress disorders.
On the basis of these findings, we tested the
hypothesis that micronutrients like folic acid and
ascorbic acid could conversely induce an
antidepressant-like effect in rodents.
Methods: The impact of chronic treatment with
folic acid, ascorbic acid or the SSRI fluoxetine
was investigated on the behavioural outcomes of
chronic restraint stressed rats in association with
assessment of brain antioxidant status, biomarkers
of oxidative damage, changes in body weight
and histological lesions.
Results: Restraint stress caused anhedonia and
behavioural despair, along with depletion of
antioxidants SOD, CAT, GST, GR, GSH, and
increase in lipid peroxidation and protein carbonyl
contents. As with ascorbic acid, treatment of
restraint-exposed animals for 21 days with folic
acid reversed the altered antioxidant defenses.
Stress induced behavioural changes were
attenuated by both folic and ascorbic acids, similar
to fluoxetine, with the normalization of decreased
body weight and restoration of brain
histopathological alterations.
Conclusion: The results indicate that changes in
depressive behavior and body weight are
associated with remarkable modulation of
oxidative stress and antioxidant defenses. Since
oxidative stress triggers/exacerbates several routes
of damage contributing to brain dysfunction and
this could be an important therapeutic target for
stress-related disorders like depression.
IL-8.
Antioxidant Potential and LDL Oxidation in Disease.
Dr. Neelima Singh and Nivedita Singh.
Department of Biochemistry, G.R. Medical College Gwalior (M.P)
LDL particles are rich in antioxidants and are
resistant to oxidation. The capacity which prevents
the oxidation of LDL by free radicals is known as
antioxidant potential (AOP). Diabetics are at
higher risk of atherosclerotic cardiovascular
diseases (ASCVD) than non diabetic. Present
study which is carried out in 20 healthy control,15
56
regulated D.M (by medicines) and 20 unregulated
diabetic mellitus subjects reveals that sensitivity
for LDL oxidation is increased significantly in
unregulated diabetes mellitus subjects (P<.001) as
compared to regulated diabetic group and control
group along with reduced antioxidant potential
(P<.001).
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-9.
Total Quality Management in Health Laboratories
Dr. Ghassan Shannan
IFCC Treasurer, E-Mail: [email protected]
Total Quality Management Concepts in Health
Laboratories became a necessity in analytical
laboratories. In USA and Europe various standards
are used to implement and enforce Quality
Management. However, the basic criteria for TQM
are similar on both sides of the Atlantic. This paper
will address the principles of TQM, International
Standards, and Review of International
Organisation Guidelines. Competence, Safety,
Decision Making, Quality, Reliability, Precision,
Accuracy, Contracting, Continuous Education,
Traceability, Validation & Interpretation of Results
all are part of any TQM programme. It is in the
interest of Patients, Society, Health providers,
Insurance Companies and Governments that
Medical Laboratories performance is of High
Standards of Professional and Technical
Competence, due to the followings:
Diagnosis, Prognosis and Treatment of various
diseases are frequently based on the results and
interpretations of Laboratory Tests.
Patients and Clinicians may not have sufficient
technical knowledge to determine whether a
laboratory operates at satisfactory level.
In many cases patients and/or clinicians have no
choice of laboratory.
Laboratory Tests are expensive and they are
expected to provide valid information.
It is of the interest of competent laboratories to
verify their competence through a process of
inspection.
TQM Process should include all laboratories and
in-vitro diagnostic activities including physician
office laboratories and point-of-care testing. TQM
should include regular inspection of:
1. Premises & other Facilities
2. Qualification of Lab Directors.
3. Qualification of Technical Staff.
4. Equipment.
5. Organisation & Administration.
6. Ethics.
7. Quality Policy.
TQM may be achieved by implementing ISO
standards of which 15189 – 2007 is the more recent
ISO dedicated for health laboratories. ISO 15189
addresses various aspects of Medical Laboratory
Practice which include:
1. Scope of the standard.
2. Normative references.
3. Terms and definitions.
4. Management requirement.
IL-10.
Beyond Means and SDS: Recommended Statistics for Knowledge Extraction from
Accumulated Pathology Data and Your Practice Experience
T F Hartley
Quality Manager, Pathology Services, Royal Hobart Hospital, Hobart, Tasmania, Austalia.. Email:
[email protected]
Objective : Clinical Biochemists have been
largely focussed on parametric statistical tests such
as means, standard deviations, coefficients of
variation, linear regression and correlation
coefficients. These tests are suited only to
parametric data which conform to the criterion that
the data analysed have been drawn from a notional
‘larger’ parent dataset that when plotted as a
57
Indian Journal of Clinical Biochemistry Supplement, 2009/24
histogram conforms to the ‘Normal Error Curve’.
In this paper the focus is on those statistical tests
which can be used on datasets upon which we have
no way of confirming that they are part of a “
‘larger’ parent ‘Normal Error Curve’ “. This is
particularly true of datasets from diseased patient
populations. Such datasets are more probably
skewed due to disproportionate mixing of data
from patients with ‘mild’, ‘moderate’ and ‘severe’.
Rather than risk applying invalid parametric
statistical tests to such datasets and thereby being
led into making misleading conclusions, the
recommendation of this paper is that more use is
made of non-parametric statistical tests. By going
down this non-parametric path we can enter the
new field of network analysis – the foundation of
‘knowledge mining’ – and discover new and
unexpected interdependences in our datasets.
Methods: Wherever possible either Excel or web
based calculators have been used to illustrate
performance and the advantages. Non-mainstream
Statistics Geometric Mean Regression, Rank
Order Correlation, Logistic Regression; Statistics
for Small Studies Chi Squares Mann Whitney U
Test; Statistics for Knowledge Mining ANOVA,
Repeated Measures ANOVA Multiple Linear
Regression CHAID Analysis Bayes Theorem
Bayesian Analysis of Questionnaire Data using
Bayesware Discoverer
that the local labs are reading 8% lower than the
National labs. y on x regression : Local = 1.079
* National – 0.3537 x on y regression : National =
0.9236 * Local + 0.5783 Geometric Mean
Regresion : Local = 1.081 * National - 0.4881
Multiple Linear Regression has been used to derive
an equation that predicts the ionized Ca
concentration in plasma : Calculated Ca2+ = 0.423
* Total Ca + 0.690, - 0.00620 * Albumin - 0.00149
Globulins, - 0.00257 Bicarbonate - 0.00433 *
Anion Gap, - 0.033 * Phosphate
Results: Results from studies using each of these
statistical tests will be presented. Three of the most
interesting results were in the relation to
Geometric Mean Regression, Multiple Linear
Regression and the Bayesian Network analyses.
Geometric Mean Regression has been used to
examine the relative performance of three local
laboratories (y) and 93 National laboratories (x)
in an External QA program for TIBC analyses. Y
on x and x on y regressions both suggests either a
+ 8% or a -8% systematic bias depending upon
your point of view, local or National. The
geometric mean regression analysis however
suggests that the consensus agreement should be
90% of patients with normal creatinines would
have low ureas
58
(All parameters are in SI units). The Bayesian
Network analysis of data from two cohorts of
medical inpatients – one before the changeover
from a Vitros 950 to an Abbott Architect and one
after revealed the following ‘rules’ based on the
assumption that the clinicians did change over to
the new reference intervals :
They would form the impression that there were
more low and fewer high Na and bicarbonate
results.
77% of patients with high K’s would also have
high ureas.
Only 55% of patients would have normal ureas
and K’s.
59% of patients would have low K’s and normal
ureas.
33% of patients with normal creatinines would
have high ureas.
Conclusion: Now is an opportune time to expand
our use of statistics in the clinical laboratory. We
have particularly stable analytical platforms so we
should spend more time on the objective
examination of the very large amounts of data these
systems produce. Within these datasets is a rich
resource of knowledge that can only be appreciated
after the application of robust and multiparameter
statistical tests that go beyond our usual practice.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-11.
Web Based Education and Training in Clinical Laboratory Services
Dr. Uday Donde
Director, UXL Advisor, Mumbai
Web based education, a powerful tool in the
education system, can help in imparting defined
knowledge, conducting assessment regarding
knowledge absorbed in terms of feedback and
examination, and developing skills through
animation. A simple platform to log on through a
personal computer having internet connectivity,
and registration of the user giving his specific
requirements is imperative. Specific identification
or password is given by the service provider to
begin the process of imparting education. Several
options are offered and a variety of software is
available. A report card or performance rating can
be generated to strengthen the student’s efforts.
As the student progresses, difficult level of the
examination can be increased, in order to create
further interest and increase knowledge. The
advantage of web based education is that a student
can learn what he wants, even from home, at his
own pace, whenever he wishes. (The “whatever,
whenever, wherever, however” concept). It is
advisable to supplement web based education with
on bench or in-field training in the field of clinical
laboratory services. This can best be achieved by
using animation / computer simulation which
should be corroborated with actual practical work
by providing self generated standard operating
procedures. This computer aided comprehensive
teaching – learning system can be employed to
any profession teaching, clinical laboratory
services, entrepreneurship etc. Besides web based
education in clinical biochemistry web based
awareness on regulatory bodies governing the
discipline of clinical biochemistry can also be
achieved. Salient information regarding the nature
of governance / regulation can be communicated
by providing links. The examples of such bodies
are IS / ISO, Government Ministries per se, FDA,
ICMR, MCI, NABL, Pollution Control Board, etc.
A handful of IT companies have shown interest in
developing this field for training clinical
biochemistry professional using virtual classroom
and e- learning methods. This would add value to
the academic and applied components of this
discipline. An exposure to this concept will be
presente
IL-12.
Lean - Sigma Metrics Protocol of Total Quality Management in a
New Laboratory Set-up
Barnali Das
Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai.
Objective: We aimed for Lean-Total Quality
Management (TQM) for setting up the
Biochemistry & Immunology laboratory for a 725
bedded new tertiary care hospital in Mumbai.
Methods: Components of TQM include all
divisions of the organization, namely, laboratory
operations,
information
management,
documentation and record maintenance, materials
59
Indian Journal of Clinical Biochemistry Supplement, 2009/24
and purchase, customer care, safety etc. During
the initial phase, we validated all the techniques
and new tests by verifying reference intervals,
analytical accuracy and precision, inter-assay and
intra-assay variations, analytical sensitivity,
linearity and reportable range.
Results: We take the example of alkaline
phosphatase (ALP) processed during start-up
phase of our laboratory to enumerate the above
validation steps. Reference range obtained for ALP
was 42.2 - 108.8 IU/L, which is within the
manufacturer’s reference range (30 - 120 IU/L).
Comparison of analytical accuracy between two
laboratories gave, y = 0.98x + 4.93, with r2 = 0.99,
establishing a high degree of linear correlation,
validating our laboratory procedures. Precision
verification from 15 replicates gave a coefficient
of variation (C.V.) of 1.04%, comparable with the
manufacturer’s claim. Intra- assay variations were
also within acceptable range (C.V. = 1.54%). 20
blanks were all within the stated blank value,
implying analytical sensitivity. Analytical
measurement range (AMR) was verified as
different levels of control sera were comparable
with the manufacturer’s claim, with C.V. 1.26%
and 0.69%, for level I and level II, respectively.
The standardized test showed good linearity with
different dilutions; recovery too was within an
acceptable limit (90-110%), with y = 0.99x – 2.81
and r2 = 0.99 between expected and observed
values.
Conclusion: We designed the entire loop of testing
process, including pre-analytical, analytical &
post-analytical phases according to the lean
principle through pneumatic system and sigma
metrics through DMAIC principle, i.e., Define,
Measure, Analyze, Improve and Control. This and
validation eliminates error in test results which is
important from the view point of both patients, as
well as of professional and regulatory bodies in
the health care domain.
IL-13.
Laboratory Management of the Metabolic Syndrome
Sridevi Devaraj
Professor, Pathology, Director, Special Chemistry and Toxicology, University of California Davis
Medical Center, Sacramento, California, USA; [email protected]
The metabolic syndrome afflicts approximately 1
in 4 American adults and is prevalent in many industrialized countries. Furthermore, the prevalence of the metabolic syndrome is on the increase
in Asian Indians. The metabolic syndrome confers at least a 2 fold risk of cardiovascular disease
and at least 5 fold increased risk for subsequent
diabetes. The features of the metabolic syndrome
include abdominal obesity, an atherogenic
dyslipidemia manifesting as elevated levels of triglycerides, low levels of HDL-C, and a preponderance of small dense LDL particles. Other features
include raised blood pressure, insulin resistance
and/or glucose tolerance, and associated increased
60
inflammation. The laboratory plays a critical role
in the diagnosis of the metabolic syndrome since
of the 5 features, 3 are laboratory based, including
triglycerides e”150mg/dL (1.7mmol/L), HDL-C
levels <40 mg/dL (1.1mmol/L) and 50 mg/dL
(1.3mmol/L) ( in men and women respectively)
and fasting plasma glucose e”100mg/dL (5.6mmol/
L) . In addition, it is not uncommon for patients
with metabolic syndrome to have non-alcoholic
steatosis hepatitis (NASH), generally diagnosed
by an increased in transaminases with ALT/AST
ratio >1 and sonographic evidence of fat accumulation in the liver. Also, patients with the metabolic syndrome can have hyperuricemia and
Indian Journal of Clinical Biochemistry Supplement, 2009/24
microalbuminuria. With regards to the atherogenic
dyslipidemia since the laboratory reports in a standardized fashion triglycerides, HDL and LDL cholesterol, it is also incumbent on the clinical laboratory to report the non-HDL-C which embraces
all the atherogenic ApoB carrying particles. It is
simply obtained by subtracting HDL cholesterol
from the total cholesterol. The non-HDL-C is especially important in patients with triglycerides
e”200mg/dL (2.25mmol/L) and the goal for nonHDL-C is the LDL goal plus 30mg/dL (0.77mmol/
L). Thus, in a patients with diabetes and metabolic syndrome, a LDL-C goal would be <100mg/
dL (2.6mmol/L) and non-HDL-C would be
<130mg/dL (3.3mmol/L). Other abnormalities
that have been reported in the metabolic syndrome
include elevated levels of remnant and remnant
like particles and small dense LDL. Also, patients
with the metabolic syndrome have elevated levels of ApoB, which is a better predictor of outcomes in statin trials than LDL-C.
Microalbuminuria is also relatively easily measured in the clinical laboratory and indeed can be
done on a spot urine sample, expressing it as albumin/creatinine ratio. Microalbuminuria defined
as between 30 to 300 ug/mg of creatinine would
also encourage the clinician to better manage the
patient especially with regards to hypertension and
abnormal glucose tolerance. C-reactive protein
(CRP) levels have been shown to predict cardiovascular events when measured by the high sensitivity (hs) assay and in fact are elevated in patients
with the metabolic syndrome and appears to confirm greater CVD risk . A hsCRP level in patients
with the metabolic syndrome between 3-10 mg/L
could inform the clinician to better target the
prothrombotic/proinflammatory status of the patient with therapeutic lifestyle changes and pharmacotherapy. Another very important adipokine
that has great relevance to the metabolic syndrome
is decreased levels of adiponectin. Lastly, whilst,
some measure of insulin sensitivity can be obtained
by using the homeostatic model (HOMA-IR), insulin assays are not standardized and thus any recommendation for reporting HOMA or QUICKI
measures of insulin resistance requires better standardization for clinical diagnosis. Other circulating biomarkers such interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), leptin, PAI1 retinol binding protein-4, may be relevant in
metabolic syndrome but belong to the research
arena presently.
IL-14.
Thyrotropin Secreting Pituitary Adenomas (TSHoma)
V.Parameswaran, G.Stilwell and J.Burgess
Diabetes and Endocrinology Services, Royal Hobart Hospital, Tasmania, Australia
Thyrotropin (TSH) secreting tumours of the
pituitary are uncommon and account for <1% of
all pituitary tumours. Although, TSHoma are a rare
cause of hyperthyroidism, it should still be ruled
out in the diagnosis of hyperthyroid patients. TSH
secreting tumours are slow growing and
consequently establishing a positive diagnosis may
take several years. Compared to males, females
have a slightly higher rate (55%) of these tumours
Laboratory results for thyroid function can be
variable from normal to very high results.
Radiological evaluation is required and exclusion
of other biochemical abnormalities is critical in
establishing a positive diagnosis of TSHoma. The
steps involved in differential diagnosis will be
presented and discussed using a clinical case.
61
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-15.
Monogenic Disease in Endocrinology
Tjin-Shing Jap
Section of Biochemistry, Taipei Veterans General Hospital, Taiwan, ROC 112
Monogenic disease is relatively quite common in
the field of Diabetology and Endocrinology.
Maturity-onset diabetes of the young (MODY) is
responsible for only 2-5 % of type 2 diabetes in
western population. It is also an autosomal
dominant disorder with a typical age of onset of
less than 25. Recently, we have identified two
patients with MODY3 had missense mutations in
exon 3 of the HNF-1á gene (Y218C and R272H,
respectively) in a region of the protein that
corresponds to a predicted DNA binding domain.
Homozygous-trait hypercholesterolemia is due to
mutation of gene encoding LDL-receptor, may
cause severe xanthomatosis and early death by the
age of 30. We identified 5 missense of mutations
and one large deletion in LDLR gene, including
one novel mutation in Taiwan. Mutation of gene
encoding lipoprotein lipase may cause family
hypertriglyceridemia with clinical manifestations
of pancreatitis and early atherosclerosis. L252V
mutation is the most common in Taiwan. Complete
TBG deficiency may be misdiagnosed as a case
of clinical hypothyroidism. We have found two
cases with complete TBGD due to novel TBG gene
mutations (S52N and W280Y). Familial
hypocalciuria hypercalcemia is due to a mutation
of the gene encoding calcium sensing receptor. We
have reported a case with the long-standing benign
hypercalcemia due to R648X mutation of CaSR
gene. To our knowledge, it is the first case of FHH
reported with CaSR gene mutation in China and
Taiwan. We have identified the MEN1 gene
mutation of nine Han Chinese families with MEN1
living in Taiwan, including five novel mutations.
Recently we have also found a patient with CAH
due to a compound heterozygous mutations of
R362C and P409R in the P450c17 (17-??hydroxylase/ 17,20 Lyase) Gene. In recent years,
we have successfully identified several families
with clear single gene mutation causing
hypercholesterolemia, Familial Hypocalciuric
Hypercalcemia, Thyroid binding globulin
deficiency, Alpha-lipoproteinemia, Familial hypertriglyceridemia and MODY, MEN1, Pendred
syndrome and Congenital Adrenal Hyperplasia,
respectively.
IL-16.
Obesity – A Global Epidemic
Dr. Nalini Ganesan
Professor, Department of Biochemistry, SRMC & RI, Sri Ramachandra University, Porur, Chennai – 116
The growing prevalence of obesity worldwide is
an increasing concern surrounding the rising rates
of type-2 diabetes, cardiovascular disease and
consequent health and financial implications for
the population. The United States has the highest
prevalence rates of obesity worldwide, now
exceeding 30 %. Moreover, the prevalence of
obesity is rising in developing countries. The
62
etiology of obesity is multifactorial and rapid rise
in prevalence of this epidemic throughout the world
has indicated that the environmental changes are
the major determinants modifying the individual
susceptibility to these environmental factors. The
root cause for obesity being energy imbalance and
is associated with significant morbidity and
mortality. The classical problems associated with
Indian Journal of Clinical Biochemistry Supplement, 2009/24
obesity range from mechanical such as
osteoarthritis and sleep apnea to metabolic
perturbations resulting in type 2 diabetes,
hyperlipidemia, hypertension and overall
increased cardiovascular risk. There is also an
increasing realization that obesity is associated
with higher risk for developing certain cancers.
This review addresses physiological and
neuromolecular mechanism regulating energy
balance by focusing on adipocyte metabolism,
adipocyte dysfunction, etiopathogenesis,
environmental and genetic determinants,
mitochondrial dysfunction and secondary
pathologies promoted by obesity. Greater insight
into mechanism behind this may improve our
understanding of how to prevent and best manage
this complex condition. We are planning to
produce our experimental evidence on the
biochemical and genetic aspect pertaining to
obesity.
IL-17.
Novel Interactive Signal Molecules in the Hypothalamus Regulating GNRH Release
Dr. Edathil Vijayan
Centre for Neuroscience, Dept of Biotechnology, Cochin University of Science &Technology,
Kochi -682 022 Kerala..
The human brain has mystified people throughout history. Though it weighs a mere 1.5kg and is
small enough to hold in our hands, it is our body’s
most vital organ. It’s complex network of 100 billion or more nerve cells orchestrates every aspect
of our thoughts, perception and behavior. More
than anything else, our brain defines who we are.
Brain is remarkably plastic and continues to
change throughout life in accordance with our
experiences. Brain, behavior and environment are
all intricately linked in an interactive loop: changes
in the environment leads to changes in behavior
which lead to changes in the brain. Immune cells
which constitute the body’s biological defense
against infections and toxins have many things in
common with nerve cells. One of the most exciting findings in recent years is that neuroendocrine
system and immune system communicate through
common biochemical language. Cytokines released from cells of immune system inhibit gonadotropin releasing hormone (GnRH) release an
action similar to that of nitric oxide synthase
(NOS) inhibitor. Nitric oxide (NO), an ubiquitous signal molecule, plays a crucial role in a host
of biological systems including the brain as a neurotransmitter. Nitric oxide synthase (NOS) containing neurons occur in the hypothalamus where
the perikarya are located in paraventriculr and supraoptic nuclei their axons project to the neural
lobe of the pituitary gland , the structure that contain the largest quantity of NOS of any organ in
the body. When both NOS inhibitor and cytokine
were added together, both in vivo and in vitro incubation systems there was an additive suppressive effect on GnRH/ LH release. Our understanding of these complex interactions between the brain
and the immune system is revealing targets for
therapeutic intervention. For instance, possibility
of various vaccines that might arrest or slow the
progress of brain tumor growth or Alzheimer’s
disease and clinical trials of an immune therapy
for spinal cord injury are underway. (Supported
by ICMR, India).
63
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-18.
Role of Ethanol in Inducing Inflammatory Brain Damage and Vasculogenesis
Sukhes Mukherjee #, Subir Kumar Das$,
Subrata Chattopadhyay, and D.M Vasudevan #
Department of Biochemistry, Amrita School of Medicine, Kochi-682026, $ Department of Biochemistry,
Agartala Govt Medical College, Kunjaban P.O., Agartala 799 006, * Bio-organic Division, Bhabha
Atomic Research Centre, Mumbai 400 085; [email protected]
Background: Ethanol is a small molecule that has
a negative impact on human health and moderate
to heavy doses of alcohol have deleterious effects
and especially on brain and its different
compartments. Ethanol is also responsible for
degenerative changes in brain.
Methods: In the present study with Male Wistar
rat, we investigated the role of natural antioxidants
like grape polyphenols and Vit E in combating
the ROS balance in alcoholism for a dose of 4g /
Kg b.w/day of ethanol for a period of 12 weeks.
Results: Ethanol intoxication in brain upregulates
COX-2, iNOS levels and p38 MAPK pathways
as evidenced by immunohistochemical studies of
different sections of brain, and increases cell death
in different brain compartments as evidenced by
Caspase-3 and Caspase-8 expression and TUNEL
assay by Immunohistochemistry.
Conclusion: Grape polyphenols show protective
effect to ethanol induced brain damage by
regulating the inflammatory processes with the
alteration of the VEGF receptors (flk1 and flt1)
and VWF-VIII facilitating vasculogenesis. These
findings indicate that exposure to ethanol for a
higher dose induces brain damage triggering the
inflammatory processes and leads to neuronal
apoptosis.
IL-19.
Culture of Rat Gastric Mucosal Cell Line RGM1 or its Tumor Cell Line RGK1
Combined with Human Fibroblasts
Hideyuki J Majima1), Yoko Yamaguchi2), Mitsuhiro Ohshima2), Hiroko P Indo1), Kazuo
Tomita1), Yoichiro Iwashita1), Hsiu-Chuan Yen3), Takuro Kodama1), Masakazu Souda1),
Akihide Tanimoto1), Motoharu Miymoto1,4), Kazuyuki Noguchi4), Osamu Shimokawa5)
Yumiko Nagano5), Tsuyoshi Kaneko5), Hirofumi Matsui5), and Toshihiko Ozawa6),
1)
Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences,
Kagoshima 890-8544, Japan, 2Department of Biochemistry, Nihon University School of Dentistry, Kanda
101-8310, Japan, 3)Graduate Institute of Medical Biotechnology, Chang Gung University, Kwei-Shan, TaoYuan 333, Taiwan, 4)Department of Periodontology, Kagoshima University Graduate School of Medical
and Dental Sciences, Kagoshima 890-8544, Japan, 5)Division of Gastroenterology, Graduate School of
Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan, 6)Department
of Health Pharmacy, Yokohama College of Pharmacy, Totsuka 245-0066 Japan.
Hideyuki J Majima: [email protected]
Studies using cell culture have benefits to provide bioenvironmental condition or factors. However,
selective
data
excluding
complex sometimes the data will not reflect in vivo
64
Indian Journal of Clinical Biochemistry Supplement, 2009/24
conditions due to lack of physiological or
pathological conditions where interactions of
different types of cells would exist. Besides in
vivo, in vitro 3D cultures with different types, e.g.,
epithelial cells and fibrobasts will provides new
aspects of interactions between the two types of
cells. A rat normal gastric mucosal cell line RGM1
or its tomorized cell line RGK1 were used to
perform 3D culture with human fibroblats. Human
fibroblasts were cultured in collagen type I and
RGM1 or RGK1 were cultured on the collagen as
3D cultures. 3D cultures with RGM1 or RGK1
cells with only collagen resulted monolayer
growth on collagen, whereas those cell 3D cultures
with human fibroblasts showed appearances of
activation in both the epithelial cells and
fibroblasts, suggesting the interactivity between
the two types of cells. Particularly, in RGK1 cells
grew with multiple cell layers (the layers), and
fibers and fibrous margin were found inside the
layers and in collagen site facing the layers.
Results by treatment of a matrix metalloproteinase
(MMP) inhibitor using Marimastat to the 3D
cultures showed disappearance of activation of
both the epithelial cells and fibroblasts or
dissociation of the interactivity.
IL-20.
Cancer Biomarkers of Prognostic Value
Paturu Kondaiah
Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science,
Bangalore 560 012. E-mail: [email protected]
The field of Biomarkers that can predict the course
of the cancer progression has been an important
area of intense research in recent times. Gene
expression profiling using gene microarrays has
been the choice of investigation for a high throughput analysis and identification of biomarkers. Our
group has been working with cancer and pre cancer tissues to identify novel biomarkers of prognostic value. We carried out microarray analysis
of glioma tumors of different grades using cDNA
microarray. Data analysis identified several differentially regulated genes between normal brain
tissue and various grades of gliomas. Further,
several novel genes are differentially expressed
between grades II/III astrocytoma (low grade) and
glioblastoma multiforme (GBM; grade IV). By
real time PCR analysis we found differential regulation of several genes in the Notch signalling pathway such as ASCL1 (Hash 1), Hes1, Hes6 and
Delta1. In addition, differential expression of many
other already known and novel genes in gliomas
has been identified. Real time PCR validations of
some selected genes are in agreement with the array results. Genes that show differential regulation are in the categories of transcription factors,
signalling intermediates and secreted factors. In
addition, we found expression of few genes correlating with prognosis of the GBM patients. Our
data could form a basis for building diagnostic/
prognostic gene signatures in glioma progression
and novel therapeutic targets.
IL-21.
HPV 16 Variants in Normal, SIL and Cervical Cancer Women.
Neeta Singh1, Chandresh Sharma1, Archna Singh1 Palika Datta1 and Sunesh K. Jain2
Departments of Biochemistry1, Obstetrics and Gynecology2, AIIMS, New Delhi – 110029, India.
E-mail: [email protected]
Background: HPV is a causative factor in cervical
carcinogenesis with HPV 16 being the most
prevalent. E6 and E7 proteins are associated with
transformation and immortalization, whereas L1
65
Indian Journal of Clinical Biochemistry Supplement, 2009/24
is a capsid protein responsible for virus assembly.
Objective: We investigated variants prevalent in
HPV 16 E6, E7, L1 genes in Northern India, in
normal, SILs and cervical carcinomas and their
possible biological effects.
region. Some of these led to amino acid changes
such as R10G, Q14H, D25N, D25E, S71C, H784Y,
and the most prevalent being L83V. E7 showed a
total of 7 variants, with F57V being the most
prevalent. L1 showed a maximum of 58 variants
Methods: Cervical scrapes/biopsies were in tumors, with Ins 448S and D465 Del being the
collected, DNA extracted and examined for the most prevalent.
presence of HPV by PCR using consensus MY09/ Conclusion: Similar variants were seen in
11 primers and for HPV 16 using type specific normals, SILs and cervical carcinomas, but to
primers. HPV 16 variants were characterized by varying extents. The identified variants some new
full length sequencing of L1, E6 and E7 genes.
and some already reported can disrupt virus
Results: 89% of normals, 100% of SILs and 71%
of HPV 16 positive tumors showed the presence
of the European variant class, mainly E350G and
E350T. A total of 18 variants were seen in E6
assembly and transcription, P53 degradation, B and
T cell epitopes and are thus important in viral
persistence and progression to cervical cancer, and
also in vaccine development
IL-22.
An Update in Molecular Oncology: Cervical Cancer
B.Nagarajan
Cancer Institute Chennai- 600 020, Email: [email protected]
In the Asia-pacific region incidence of cervical
cancer cervix is high second to breast cancer.
Prognosis of invasive carcinoma is based mainly
on subjective clinical staging. Abnormalities in
cytokine production have been found in invasive
cervical carcinomas. A correlation between
cytokine expression and different clinical
parameters such as tumor and lymph node status,
HPV expression and disease free survival were
evaluated. Human Papilloma Virus (HPV) is the
major cause. A total of 43 cervical biopsies
collected from sequentially enrolled patients were
analyzed by DNA amplification and sequenced
to determine the HPV genotype. Samples with
multiple infections were resolved by multiplex
PCR combined with array primer extension
(APEX) Nine different HPVs mainly 16 and 18
were detected. Multiple HPV infections correlated
prominently with lack of treatment response
compared with single type infection that again
reiterates the risk of treatment failure. Cytokine
66
studies address macrophages and dendrite cell
infiltration, role of IL-17, IL-6 and 8 as prognostic
markers, levels of both T helper cells 1 and2
cytokines and T cell anergy. Furthermore DNA
adducts represent an early detectable and critical
step in carcinogenesis and may serve as an internal
dosimetry of carcinogen exposure. To determine
changes in oxidative and other DNA adducts.
During cervical cancer development, we analyzed
DNA from specimens collected from cervicites,
biopsy-proven dysplasia and invasive cancer cases.
These toxic biological end-points could as well
form therapeutic indices in the management. An
offshoot of this approach is to monitor DNA
adducts levels in patients undergoing radiotherapy.
Our data tend to support the commonalityinfection, inflammation and release of ROS. The
bottom line is prognosticate and stratify patient
response based on data base that would end result
in ultimate patient care and viable point-of-care
diagnostics.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-23.
Natural Products as Potential Treatments for the Human Metabolic Syndrome
Lindsay Brown
School of Biomedical Sciences, The University of Queensland, Australia
Metabolic syndrome is the clustering of abdominal obesity, insulin resistance, dyslipidaemia,
hyperglycaemia, a prothrombotic state and hypertension that increases the risk of cardiovascular
disease and fatty liver in humans. Diets rich in
carbohydrates and saturated fats contribute to the
signs of the metabolic syndrome. Animal models
that mimic the range of pathophysiological
changes seen in humans diagnosed with metabolic
syndrome are necessary to understand the initiation and progression of metabolic syndrome and
the development of new treatments. The metabolic
changes and the structure and function of the heart
and liver were characterised in young adult male
Wistar rats fed a high carbohydrate/high fat diet
for 16 weeks. These rats developed many of the
chronic signs of the metabolic syndrome in humans including hypertension, impaired glucose
tolerance, increased oxidative stress, plasma lipid
abnormalities, excess deposition of abdominal visceral fat, increased waist circumference, ventricular dilatation with hypertrophy and decreased contractile function, impaired conduction, increased
inflammatory cell infiltration into the myocardium
and liver resulting in fibrosis, an increased stiffness of the heart, endothelial dysfunction as a decreased response to acetylcholine and increased
plasma concentrations of liver enzymes. Further,
oral chronic treatment with curcumin or rutin attenuated or reversed these structural and functional
changes in the heart and liver. Thus, this dietaryinduced model of the metabolic syndrome in rats
may provide a realistic and useful experimental
tool to evaluate the development of symptoms and
their reversal by potential treatments such as natural products.
IL-24.
Association of Cytokines and Insulin Resistance in Non-Alcoholic Fatty Liver Disease
Subir Kumar Das
Department of Biochemistry, Agartala Govt Medical College, Kunjaban P.O.,
Agartala 799 006, Tripura, e-mail: [email protected]
Background: A number of factors are linked with
non-alcoholic fatty liver diseases (NAFLD), a
condition that ranges from clinically benign fatty
liver to its more severe form, non alcoholic
steatohepatitis (NASH).
Objective: To evaluate the role of anthropometric
profile, lipid profile, insulin resistance data, pro-
inflammatory and anti-inflammatory cytokines in
NAFLD patients.
Methods: A complete clinical history, including
body mass index and waist-to-hip ratio were
obtained in 105 NAFLD patients (89 male and 16
female) and 77 normal subjects (45 male and 32
female). Blood collected after over night fast was
67
Indian Journal of Clinical Biochemistry Supplement, 2009/24
used for the determination of biochemical
parameters including glucose level, insulin level,
lipid profile and cytokine estimations. Insulin
resistance was calculated by the homeostasis
model.
Results: Predisposing factors were diabetes
mellitus (35%), overweight (56%) and
hyperlipidemia (44%). Insulin resistance was
confirmed in 70% NAFLD patients, and 42%
fulfilled minimum criteria for insulin resistance
syndrome. NAFLD patients showed elevated
levels of TNF-a and TGF-b1, while IL-4 level
decreased significantly compared to normal
subjects.
Conclusion: Insulin resistance and cytokines may
be responsible for fibrogenic processes in NAFLD.
Acknowledgement: Financial assistance received
from Van Slyke Foundation- Critical and Pointof-Care Testing (VSF-CPOCT) Research Grant;
American Association for Clinical Chemistry is
gratefully acknowledged.
IL-25.
The Promise of Stem Cells and Gene Therapy as Novel Approaches to the Treatment
of Multiple Sclerosis (MS)
Natalie Payne1, Christopher Siatskas1, Guizhi Sun1, Daniella Herszfeld1, Natalie Seach1,
Sara Litwak1, Martin Short1, Ban-Hock Toh2,Frank Alderuccio3, Thomas Backstrom4,
Richard L Boyd1and Claude C A Bernard1
1
Monash Immunology and Stem Cell Laboratories, Monash University, Clayton, Victoria, 3800, Australia. 2Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton,
Victoria, 3168, Australia. 3Department of Immunology, Monash University, Melbourne, Victoria 3004,
Australia. 4Malaghan Institute of Medical Research, Wellington, 6012, New Zealand.
Multiple sclerosis (MS) is a disease that affects
the central nervous system (CNS) with significant
human and community costs. Although the precise trigger(s) remain elusive, the ultimate end
point of the disease is the destruction of nerve
axons and myelin, two key cellular components
of the CNS involved in the conduction of nerve
impulses. As a consequence patients with MS suffer from numerous neurological problems. At
present, there is no cure for this severe
68
neurodegenerative condition. Although, immune
therapy is beneficial to a proportion of patients,
others do not respond to any currently available
therapies. A rational approach to the treatment and
cure of autoimmune diseases such as MS requires
incorporation of three fundamental processes: suppression of the inflammatory response, regeneration of the target cells or tissues and restoration of
self tolerance, whereby damaging white immune
cells can be purged or silence. Current clinical
Indian Journal of Clinical Biochemistry Supplement, 2009/24
practice at best addresses the first problem but
in these mice. These findings demonstrate that
there are no clear strategies for the later two. To
MSC isolated from different tissue sources have
address these issues we are using experimental au-
distinct effects both in vitro as well as in vivo.
toimmune encephalomyelitis (EAE), a model for
Having demonstrated that MSCs have the ability
MS, induced by immunization with the myelin oli-
to modulate the pathogenic immune response in
godendrocyte glycoprotein (MOG), a key
EAE and thus might be of potential therapeutic
autoantigen in MS. Due to their multipotentiality,
relevance to MS, we next attempted to restore
broad immunomodulatory properties and poten-
immune tolerance to MOG by intrathymic injec-
tial to facilitate repair of damaged tissue, mesen-
tions of a lentiviral vector engineered to express
chymal stem cells (MSC) hold great promise for
MOG (LV-MOG) or the hydrogen potassium AT-
treatment of central nervous system and other dis-
Pase -an irrelevant autoantigen (LV-HKATPase)
eases. While MSC were originally isolated from
or PBS. Neurological assessment indicated that
bone marrow, it is now recognised that many con-
untreated and control animals injected with LV-
nective tissues contain a population of MSC. In
HKATPase or with PBS, developed fulminant
this study, the therapeutic potential of human MSC
symptoms of EAE. In contrast, animals receiving
isolated from bone marrow, adipose tissue and
the therapeutic LV-MOG vector manifest little or
umbilical cord Wharton’s jelly was investigated
no signs of disease. Histological analysis of CNS
using the EAE model. All three cell types were
from control animals showed inflammatory lesions
initially characterised by their differentiation abil-
that correlated with severe areas of demyelination
ity, colony forming unit-fibroblast assays and by
and axonal loss. Notably LV-MOG-treated animals
flow cytometry using an extensive panel of anti-
demonstrated significantly fewer cellular infiltrates
bodies. Immunomodulatory properties were also
that corresponded with a lower number of demy-
assessed in vitro through T cell proliferation as-
elinating areas with little, or no axonal loss as com-
says. We next examined the effect of MSC on the
pared to controls. In LV-MOG-treated animals, a
development of chronic progressive EAE induced
reduction in the number of antigen-specific CD4+
by the extracellular domain of MOG (rMOG).
T-cells was demonstrated. Furthermore, a signifi-
While BM-MSC appeared to have little effect on
cant reduction in Th1 and Th17 cytokine levels
the disease course, disease onset was significantly
was also shown in these cultures. Collectively
delayed in mice receiving either A-MSC or U-
these data indicate that intrathymic delivery of a
MSC. Maximum clinical score and cumulative
LV-MOG represents a novel form of tolerance in-
score were reduced in A-MSC treated mice com-
duction for the treatment of MS. Collectively, these
pared to the vehicle control group. Likewise, his-
findings further add to the armamentarium of non-
tological examination revealed that inflammation,
toxic gene-based strategies for the treatment of this
demyelination and axonal loss were also reduced
debilitating disease.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-26.
Hs-CRP, Inflammation and Its Role in Coronary Heart Disease
Arun Raizada1, H V Singh2 and Naresh Trehan3
1
Senior Consultant and Head, Ex-President ACBI, Department of Clinical Biochemistry, Medicity,
Global Health Pvt. Ltd, Gurgaon-122001, 2 Biochemist, Department of Pathology, Hindu Rao Hospital, Delhi-110007, 3 Chairman and Managing Director, Medicity, Global Health Pvt. Ltd, Gurgaon.
“Inflammation” is the process by which the body
responds to injury or an infection. Laboratory
evidence and findings from clinical and population studies suggest that inflammation is important in atherosclerosis. This is the process in which
fatty deposits build up in the inner lining of arteries. C-reactive protein (CRP) is one of the acute
phase proteins that increase during systemic inflammation. It’s been suggested that testing CRP
levels in the blood may be an additional way to
assess cardiovascular disease risk. A more sensitive CRP test, called a highly sensitive C-reactive protein (hs-CRP) assay, is available to determine heart disease risk. Number of studies have
examined whether hs-CRP can predict recurrent
cardiovascular disease, stroke and death in different settings. High levels of hs-CRP consistently
predict recurrent coronary events in patients with
unstable angina and acute myocardial infarction
(heart attack). Higher hs-CRP levels also are associated with lower survival rates in these
patients. Many studies have suggested that after
adjusting for other prognostic factors, hs-CRP is
useful as a risk predictor. Studies also suggest that
higher levels of hs-CRP may increase the risk that
an artery will reclose after it’s been opened by balloon angioplasty. High levels of hs-CRP in the
blood also seem to predict prognosis and recurrent events in patients with stroke or peripheral
arterial disease. Scientific studies have found that
the higher the hs-CRP levels, the higher the risk
of having a heart attack. In fact, the risk for heart
attack in people in the upper third of hs-CRP levels has been determined to be twice that of those
whose hs-CRP level is in the lower third. The true
independent association between hs-CRP and new
cardiovascular events hasn’t yet been established.
IL-27.
Pro-oxidant Activity of Artemisinin Causes an Apoptosis Like Death in
Leishmania parasites
Mitali Chatterjee and Rupashree Sen
Dept. of Pharmacology, Institute of Postgraduate Medical Education & Research, 244B, Acharya JC
Bose Road, Kolkata Email: [email protected]
Leishmaniasis is a vector-borne disease caused by
the obligatory protozoan parasite, Leishmania sp.,
affecting over 12 million people worldwide. In
India, the emerging refractoriness to conventional
70
antimonial treatment has highlighted the need for
newer antileishmanial compounds. Artemisinin, an
established anti-malarial drug, was found to be an
effective anti-leishmanial drug, the IC 50 in
Indian Journal of Clinical Biochemistry Supplement, 2009/24
amastigotes being 22 µM. This leishmanicidal
activity was mediated by an increased generation
of reactive oxygen species, coupled with depletion
of non protein thiols; furthermore, the addition of
N-acetyl cytseine increased the IC 50 of
Artemisinin, confirming the critical role of free
radicals. This oxidative insult upon the parasite
triggered an enhanced influx of Ca++, translating
into mitochondrial membrane depolarization,
increased
annexin-V
positivity,
deoxynucleotidyltransferase-mediated dUTP nick
end labeling, finally leading to an increased sub
G0/G1 population, features of apoptosis. However,
this programmed cell death was not accompanied
by enhancement of caspase activity suggesting
non-involvement of caspases. Additionally, in vivo
experiments in L. donovani infected mice
confirmed the efficacy of Artemisinin (10 and 25
mg/kg b.w.) which was accompanied by up
regulation of intracellular levels of Th1 cytokines,
IFN-ã and IL-2 in splenocytes. Taken together,
Artemisinin is an effective leishmanicidal agent
that causes an apoptosis like death in parasites,
meriting future pharmacological studies.
IL-28.
Novel Filarial Genes or Recombinant Filarial Proteins as Effective Vaccine
Candidates
MVR Reddy
Department of biochemistry & JB Tropical Disease Research Centre, Mahatma Gandhi Institute of
Medical Sciences, Sevagram, Maharashtra -442102 (e-mail: [email protected])
The rapid progress in Filarial Genome Project has
led to the identification of variety of novel filarial
genes or recombinant proteins of Brugia malayi
or Wuchereria bancrofti as promising vaccine
candidates. These include abundantly expressed
molecules viz., abundant larval transcripts (ALT)
and venom allergen homologue (VAH),
antioxidant enzymes viz., glutathione-Stransferase (GST), superoxide dismutase (SOD),
thioredoxin peroxidise (TPX) and other crucial
enzymes like transglutaminase (TGA).
Vaccination with B. malayi enzymes SOD, TGA,
TPX induced low to moderate (30 to 46% )
cytotoxicity against microfilaria (mf) or L3 larvae
or protection against challenge B. malayi infection
in jird model. In contrast Bm ALT-2 or Wb GST
induced 69% and 61% protection respectively
against B. malayi challenge infection in jird
model. When compared to these single antigen
vaccines, fusion proteins or multiple antigen
vaccinations generally offered better protection.
Bm ALT-2 in combination with Wb GST, Bm TPX
and Bm VAH enhanced the protection to 71%, 74%
and 78% respectively. Although DNA vaccines
have several advantages over conventional
vaccines, filarial DNA vaccines particularly in
single plasmid vaccination were often not adequate
in antibody production and protection. DNA
vaccine of Bm-tga could not induce much
protection against challenge infection in mouse
model. DNA vaccines of Bm-vah, Bm alt-2 and
Bm-tpx induced only 50.2%, 55.8% and 37%
cytotoxicity respectively against B.malayi mf. In
contrast the cocktail vaccination of Bm-alt-2 in
combination with Bm-vah and Bm-tpx induced up
to 63% and 78% cytotoxicity respectively against
mf or L3 larvae. Taken together these studies
favour the use of multiple antigen vaccination with
combination of two or more antigens / genes as an
effective vaccine development strategy in
Filariasis.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-29.
Bilirubin from Toxic Metabolite to an Antioxidant: Mechanisms
S. Adhikari
Radiation and Photochemistry Division, Chemistry Group, Bhabha Atomic Research Centre
Mumbai 400 085, India Email: [email protected]
Bilirubun has two extreme roles to play in physiology. In one side it is a toxic metabolite while at
micromolar concentration it is better antioxidant
than???tocopherol and thiols. It is a toxin because
it’s association with neonatal jaundice, possibly
leading to irreversible brain damage due to neurotoxicity. On the other hand, bilirubin can act as
an important cytoprotector of tissues that are
poorly equipped with antioxidant defence systems,
including myocardium and nervous tissue. Bilirubin can suppress oxidation of lysosomes at oxygen concentrations that are physiologically relevant. The antioxidant-prooxidant mechanism of
bilirubin will be discussed in the present paper.
Our study demonstrates that hydroxyl and
glutathiyl radicals abstract hydrogen atom from
bilirubin and forms a carbon-centered radical. The
bilirubin radical thus produced, decays with first
order rate and decays faster in presence of oxygen. At a later stage bilirubin forms a peroxyl radical in presence of oxygen. This is the first direct
observation of the bilirubin peroxyl radical formation which may answer the situation of low
protection of lipid peroxidation in a condition of
higher than the physiologically relevant oxygen
concentration. Bilirubin induced toxicity may also
arise from the aforesaid peroxyl radical formation.
Linoleic acid peroxyl radical also reacts with bilirubin via hydrogen abstraction. In the case of NO2.
radical reaction, bilirubin produces radical cation
via single electron transfer reaction. These results
show that in the oxidation of bilirubin both hydrogen atom transfer and single electron transfer are
possible depending on the nature of the oxidizing
radical. HPLC analysis of the products also supports our mechanism. Another aspect of bilirubin
that will be discussed is the free radical induced
recyclization. Through its antioxidant action, bilirubin produces biliverdin as a major product. The
conversion of biliverdin to bilirubin is a physiological enzymatic process. Results from our laboratory shows that under certain condition, this recycling process from bilirubin to biliverdin and again
bilirubin back can also occur through a free radical pathway.
IL-30.
New Perspectives on the Clinical Importance and Applications of Vitamin D Testing
H.A Morris
Hanson Institute, SA Pathology, Adelaide South Australia 5000
The vitamin D system plays a primary role in the
maintenance of calcium, and phosphate
homeostasis. Recently it has been identified as
exerting a wider range of biological activities
including regulation of cellular differentiation and
proliferation and therefore it has implications for
cancer, the immune system, and reproduction. The
endocrine action of vitamin D acts through the
72
renal metabolism of vitamin D, producing 1,25
dihydroxyvitamin D (1,25D) for the circulation.
The major organ responding to plasma 1,25D is
the small intestine where it controls intestinal
absorption of calcium and phosphate. 1,25D is also
synthesised in a wide range of tissues including
bone cells where it is believed to exert an autocrine
or paracrine activity. Vitamin D insufficiency in
Indian Journal of Clinical Biochemistry Supplement, 2009/24
the elderly has clearly demonstrated an increased
risk of hip fracture. A major question for the
clinical laboratory is what is the vitamin D
requirement for a healthy skeleton? Measurement
of vitamin D status in apparently healthy
individuals merely assesses their level of sunlight
exposure and does not indicate vitamin D
requirements. Current evidence from a wide range
of sources including clinical data indicate that
levels of serum 25-hydroxyvitamin D (25D) below
20 nmol/L are clearly deficient and give rise to
osteomalacia, a bone mineralisation defect.
However evidence is accumulating to suggest that
25D levels between 20 and 80 nmol/L indicate a
depleted vitamin D status causing bone loss and
increasing the risk of fracture as well as increasing
the risk of colon cancer and infection. These
findings suggest that the lower level of the
desirable limit for vitamin D should be
significantly higher than currently used by many
laboratories
IL-31.
An Insight to the Mechanism of Lycopene: A Biocarotenoids Against ã-Radiation Induced
Apoptosis; MAPK Signaling Pathways and DNA Repair Enzymes in Normal
Lymphocytes and Lymphoblastoid TK-6 Cell Lines in Vitro.
Venugopal P. Menon
Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University,
Annamalainagar-608 002, Tamil Nadu, India.
We evaluated the effect of lycopene a dietary
carotenoid on human lymphocytes exposed to γradiation. Cells were exposed to ã-radiation at a
dose of 4 Gy in the presence and absence of
lycopene pretreatment. Lymphocytes when
exposed to ã-radiation at a dose of 4 Gy resulted
in DNA damage, delay in cell cycle, DNA
fragmentation, up-regulation of caspases-3
caspases 9, Bax, cytochrome-c and MAPK
signaling pathways and down regulation of Bcl2, DNA repair enzymes (HOGG1 and XRCC1)
and reduction in the mitochondrial
transmembrane potential when compared to
normal control. When these cells were pretreated
with lycopene and then administered radiation all
these effects were reversed. Suggesting that
lycopene offers protection to normal cells when
exposed to radiation. We also wanted to study
whether lycopene can offer protection to cancer
cells when exposed to radiation. In this context
we used lymphoblastoid TK-6 cells in culture.
When TK-6 cells was pretreated with lycopene and
then administered ã-radiation, we found that the
intensity of damage to cancer cells were much
higher when the same amount of radiation was give
to control TK-6 cells.
Thus the study shows that lycopene while
protecting normal cells acts in combination with
ã-radiation to destroy more amount of cancer cells
than in control TK-6 cells given radiation.
IL-32.
The Role of CRP in Atherothrombosis
Ishwarlal Jialal,
Professor of Internal Medicine(Endocrinology, Clinical Nutrition and Vascular Medicine), University
of California Davis Medical Center , 4635 2nd Avenue , Research 1, Room 3000, Sacramento , CA
95817 , USA.
Background: Inflammation is pivotal in all
phases of atherosclerosis. Among the numerous
73
Indian Journal of Clinical Biochemistry Supplement, 2009/24
inflammatory biomarkers, the largest amount of
published data supports a role for high-sensitivity
C-reactive protein (CRP) as a robust and
independent risk marker in the prediction of
adverse cardiovascular events in both primary and
secondary prevention In addition to being a risk
marker, there is much evidence indicating that
CRP participates in atherogenesis.
M-CSF via activation of NF-KappaB. Most
recently we have shown that it perturbs the
glycalyx, which decorates the luminal surface,
resulting in endothelial dysfunction. Many of the
effects such as impairment of vasoreacitvity,
stimulation of Tissue Factor, MMP-9 and increase
uptake of oxidized-LDL have been confirmed invivo.
Results: In this presentation, I will focus on the
role of CRP in promoting atherothrombosis by
discussing its effects on endothelial cells,
endothelial progenitor cells, monocytemacrophages, and smooth muscle cells. The most
abundant data relates to its effects on endothelial
cells; CRP inhibits eNOS via uncoupling,
stimulates monocyte adhesion, PAI-1, IL-8, and
Conclusions: CRP is clearly a risk marker for
cardiovascular disease and is recommended for use
in primary prevention. In addition, CRP appears
also to contribute to atherogenesis. However,
further in-vivo research is needed to establish its
role in atherothrombosis. This will lead to novel
therapeutic strategies.
IL-33.
The Clinically Effective Use of Available Cardiac Biomarkers.
Ray U
Department of Pathology, Royal Hobart Hospital, University of Tasmania, Australia
Heart is a non-stop pump supplying nutrition and
oxygen to the cells of the body including its own
through coronary circulations. Coronary
circulation has its unique networks. Any
derangement in its own supply would cause
cellular anoxia, trigger cellular leakage and
jeopardise its pumping function. Acute coronary
syndrome (ACS) is diagnosed by elevated cardiac
markers, ECG changes and acute chest pain/
heaviness in the chest. Although currently there
is a strong suggestion to use only the 99 th
percentile changes in serial cardiac Troponin in
the diagnosis of ACS, judicious use of multiple
cardiac markers (CK-MB, Myoglobin and cTroponin) could be useful in the early diagnosis
74
of ACS so that timely institution of either
thrombolytic or interventional therapy could be
done to save this hard working indispensable
pump. Any increase in the intraventricular pressure
or volume or both stimulate cardiac myocytes
which release B-type natriuretic peptide (BNP)
detectable immediately in the circulation. It is quite
probable that acute ischemic event alters heart
pump and brings forth a change in intraventricular
pressure and volume. Thus there should be BNP
release in the circulation. Serial assay of BNP along
with CK-MB, myoglobin and c-Troponin could be
thus used not only to diagnose ACS but also to
stratify risk associated with it and further prognosis
following therapy.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-34.
Mycobacterial ES-31 Serine Protease of Interest in Diagnosis of Tuberculosis and
HIV-TB Co-infection and with Potential as Drug Target
B.C. Harinath
JB Tropical Disease Research Centre, Mahatma Gandhi Institute of Medical Sciences, Sevagram,
India, E-mail: [email protected]
Tuberculosis (TB) remains a major threat to public health worldwide and has been declared as
global emergency by WHO in 1993. According
to the World Health Organization (WHO, 2009),
9 million new TB cases including 4 million smear
positive cases with 15% HIV- Positivity have been
reported in 2007. Seroreactivity of the purified
excretory secretory (ES) antigens ES-31, ES-43,
ES-41 and ES-6 have been assessed in pulmonary tuberculosis (fresh, relapse, chronic and latent), extrapulmonary tuberculosis and in HIV-TB
co-infection. Analysis of immune response to
these purified antigens by indirect and sandwich
ELISA using highly sensitive and semiquantitative
Penicillinase enzyme immuno assay, showed ES31 antigen as having good diagnostic potential in
pulmonary tuberculosis and in certain groups of
extrapulmonary tuberculosis in particular tuberculous lymphadenopathy, tuberculous meningitis,
whereas ES-41 was found to be more seroreactive
in abdominal and bone & joint tuberculosis. ES43 antigen was primarily recognized by serum
antibodies in relapse cases while ES-6 was useful
in contacts. Antigen assay was found to be more
sensitive than antibody based assay for detecting
tuberculosis
with
HIV
coinfection.
Immunomonitoring for presence of antigen in TB
patients under ATT, showed that ES-31 antigen
assay was useful in determining the effectiveness
of therapy and patient’s compliance. User friendly
Peroxidase ELISA has been standardized for detection of circulating mycobacterial ES-31 serine
protease (Free antigen and Immune complexed
antigen) with 70-75% sensitivity and 90% specificity and with a limit of detection of antigen at 1
ng/2?l (0.5 ?g / ml serum). Further study revealed
that ES-31 antigen is a zinc containing serine protease. Serine protease inhibitors such as pefabloc,
3, 4 dichloroisocoumarin, phenyl methyl sulphonyl
fluoride (PMSF) and metalloprotease inhibitors
such as ethylene diamine tetracetic acid (EDTA)
and 1, 10 phenanthroline inhibited 65 - 92 % of
serine protease activity in vitro. Isoniazid showed
95% inhibition on mycobacterial ES-31 serine protease. These inhibitors also showed decreased bacterial growth in axenic culture and inhibition is
further confirmed by decreased amount of ES-31
serine protease in culture filtrate. In human macrophage culture, highly inhibitory pefabloc, 1,10
phenanthroline and isoniazid inhibited infectivity
of virulent as well as avirulent M. tuberculosis
bacilli to macrophages. The enhancement of bacterial growth in the presence of mycobacterial ES31 serine protease while inhibition in the presence
of anti ES-31 serine protease antibody was observed showing the importance of enzyme for entry and multiplication of bacilli. Immunofluorescence study using Fluorescence labelled anti ES31 antibody showed the presence of ES-31 serine
protease on mycobacterial cell surface.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-35.
Autoantibodies: Is it Possible to Predict Autoimmune Diseases?
Marcos López-Hoyos
Servicio Inmunología Hospital Universitario Marqués De Valdecilla, Santander, Spain.
A good biomarker should fulfill four
characteristics: sensitive, specific, detectable in
early disease and predictive of prognosis.
Autoantibodies are the most widely used
biomarkers in the diagnosis of autoimmune
diseases and, in some cases, in the prognosis
prediction. In the last years several prospective
studies have been published supporting their utility
in the prediction of an ongoing autoimmune
disease in healthy subjects, although they are still
few and large scale studies are needed. The
prediction of autoimmune disease is of special
utility since autoimmune diseases can be preceded
by a symptom-free phase that may last for many
years. In this scenario autoantibodies may have a
high positive predictive value for the disease onset,
severity and organ-specific complications,
especially in genetically prone individuals, in
whom an environmental trigger may switch on the
disease. One of the most active areas of work at
present in autoimmunity is the development of
autoantibodies profiles to identify those patients
at risk of developing an autoimmune disease. These
autoantibody profiles can be applied to the clinical
management of healthy population and high-risk
subjects. The session will review the recent
evidence on the predictive value of autoantibodies
and will underline the future lines in this field.
IL-36.
Cell-Cycle Synchronization in Antinuclear Antibodies Detection
Petraki Munujos Vinyoles
R&D Department. BioSystems, S.A. Barcelona, Spain
Anti-nuclear antibodies (ANA) are one of the most
common parameters analyzed in the autoimmunity laboratory, and the indirect immunofluorescence technique, the major screening method in
systemic autoimmune diseases. The identification
of the immunofluorescent staining patterns on
HEp2 cells is often difficult due to the complexity of the interpretation of the images observed.
In addition, the quality of the cell culture, the developing procedure and the conjugate, among others, are the key point for a correct determination.
These cell cultures must meet some requirements
to guarantee good results, among which the presence of cells in mitosis has become a differenctial
feature when judging the suitability of the HEp2
cell slides manufacturers. There are mainly two
reasons for which it is important a certain per76
centage of cells in mitosis: the existence of autoantibodies reacting with proteins that only express during the mitosis phases, and the fact that
some patterns are similar to such an extent that
the only distinctive feature to identify them is the
staining shown by the cells in mitosis. While in an
asynchronic culture, only up to 1-2% of cells are
found in M phase, a culture that has been synchronized in early S phase can display around 10-20%
of cells in mitosis. There are several possible approaches to achieve a certain percentage of synchronized cells in an in vitro cell culture. Basically, they can be divided in biological and chemical methods, and depending on the final use of the
synchronized culture, some methods can be more
appropriate than others.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-37.
Importance of Monitoring Magnesium Levels in Cardiac Conditions
Dr. S. P. Dandekar
Professor and Head, Department of Biochemistry, Incharge Central Clinical Biochemistry Laboratory,
Seth G S Medical College & K E M Hospital, Parel, Mumbai - 400 012.
Magnesium is the fourth most abundant cation in
the body. It is present in more than 300 enzyme
systems. A lot of interest is now being focused on
the relation between magnesium and
cardiovascular diseases. The following aspects
regarding magnesium will be deliberated:-
2. The clinical relevance of total and ionized
magnesium levels.
1. The cardiac conditions under which the
magnesium level determination proves useful.
4. The correlation of other electrolyte levels with
magnesium. How important is it?
3. Preanalytical, analytical and postanalytical
factors to be monitored for magnesium
estimation in order to obtain a clinically useful
result.
IL-38.
Tissue Zinc Levels in Carcinoma
Dr. R.Selvakumar
Professor & Head, Dept Of Clinical Biochemistry, C.M.C. Hospital, Vellore - 632004
Email: [email protected]
Colon cancer is among the most common human
malignancies and remains a leading cause of
cancer related morbidity and mortality. The
transition from normal mucosa to adenoma and
its subsequent progression to carcinoma are events
that offer opportunities for preventive
interventions. The role of zinc in carcinoma
development has been the subject of debate and
reports of zinc values in the biological fluids from
cancer patients are often conflicting and
contradictory. Hence the mechanism by which
plasma zinc and tissue zinc decrease in various
cancerous tissues is still obscure. The disruption
of zinc homeostasis can play a significant role in
the development and progression of cancer. In
order to investigate the relevance of the tissue zinc
and zinc related enzymes such as CuZnSOD and
alkaline phosphatase activities in the development
of precancerous and cancerous process in the
colon, we have used well established colon cancer
model in the rat. Tissue zinc levels were analyzed
in the various parts of the G.I tract and other organs
of normal healthy rats. There was a gradual
decrease in tissue zinc concentration along the
various regions of the stomach from fundus, body
and antrum which was statistically significant. The
highest levels of tissue zinc were found in the
esophagus, testes and prostate. The DMH induced
precancerous and colon carcinoma model showed
that dysplasia and carcinoma were established
histologically in rats at four months and six months
respectively. These histological changes were
directly related to a significant decrease in plasma
zinc, tissue zinc, CuZnSOD and alkaline
phophatase activities when compared to controls
treated with saline. The mean % decrease in all
the 4 parameters was greater in the carcinoma
model as compared to the precancerous model.
Besides the significant decrease in tissue zinc and
zinc related enzymes in various parts of the G.I
77
Indian Journal of Clinical Biochemistry Supplement, 2009/24
tract (stomach and small intestine) in the
carcinoma model shows that transmural changes
along the wall of the G.I tract could be the cause
of the decrease. The above findings support the
view that decrease in tissue zinc and zinc related
enzymes are representative of biochemical
alterations in the colonic mucosa which may
reflect cellular changes that progressed to
dysplasia and frank malignancy. The high
incidence and mortality of colon cancer make
effective prevention an important public health
and economic issue. Suppression or reversal of
the carcinogenic process in the colon with nonpharmacologic or pharmacologic agent is an area
of considerable interest. Hence the role of the 3
agents such as Vitamin C, aspirin and zinc in DMH
induced precancerous and cancerous models in rat
were evaluated in this study. The results indicated
that co-administration with aspirin or vitamin C
in the precancerous and cancerous model
maintained normal histology in the colon in 88%
of rats along with a relatively lesser decrease in
colonic tissue zinc levels whereas plasma zinc and
zinc related enzymes showed no significant
changes. Co-administration with zinc in the
precancerous and carcinoma group prevented
histological changes in the colon in all rats. The
colon maintained normal histology with no
significant changes in the biochemical parameters
i.e plasma zinc, tissue zinc and zinc related
enzymes as compared to controls. In our study on
stomach cancer and colon cancer in humans, a
significant decrease in tissue zinc in the cancerous
tissue was observed as compared to their paired
non-cancerous tissue of the same individual. In
patients with prostate cancer, we observed a
significant decrease in mean tissue zinc levels in
prostate cancer and in BPH as compared to normal
prostate from autopsy cases. Plasma zinc was
significantly decreased in prostate cancer as
compared to BPH and normal subjects. Urine zinc
/creatinine ratio was significantly increased in
prostate cancer as compared to BPH and normal
subjects.
IL-39.
Prenatal Screening for Chromosomal Disorders
Päivi Laitinen
Docent, Laboratory, Oulu University Hospital, Oulu, Finland
Prenatal diagnosis has an important role in the
management of pregnancies. In Western countries
the current trend of family planning is toward
smaller families and the average age women have
babies is increasing, which increases the risk for
fetal chromosomal disorders. Today women are
also more aware of the frequency and the
importance of congenital disorders. Modern
trisomy screening combines the first trimester
serum biochemical test with the thickness of the
fetal nuchal translucency. The combined test
improves the detection rate and reduces the false
78
positive rate, compared to either biochemical or
nuchal translucency testing used alone. Pregnant
women and health care providers in Finland prefer
early testing in order to gain more time for
consideration of further procedures in case of a
positive test result. The second important issue is
to find a balance between testing sensitivity and
invasive procedures. Down’s syndrome is the
primary reason for families to seek prenatal
counseling. Effective first trimester screening for
chromosomal abnormalities is provided by a
combination of maternal age, gestational age, fetal
Indian Journal of Clinical Biochemistry Supplement, 2009/24
nuchal translucency measurement and maternal
serum free B-hCG and PAPP-A concentrations.
In Northern Finland we started prenatal screening
program in 2002. In 2002-2007 we have analyzed
25 000 samples for biochemical markers. In
17 000 cases also nuchal translucency was
measured. The screen positive rate of the combined
screening was 4.5% and the detection rate for
Down syndrome was 84%. These results are in
accordance with the published results in other
screening centers.
IL-40.
Routine Screening of Newborns for Metabolic Disorders using Tandem Mass
Spectrometry
Rohit Cariappa
Chief Scientist, NeoGen Labs, Bangalore
Routine high throughput newborn screening for
metabolic disorders using Tandem Mass
Spectrometry (MS/MS) has been carried out in
developed countries for the past 15 years. Based
on the screening of over 4 million babies the
process has been optimized such that several
hundred samples per day can be analyzed without
the direct interaction of a metabolic expert in every
sample. The false positive rate for the detection
of over 45 metabolic disorders using licensed
software and interpretation algorithms is currently
less than 0.1% and the false negative rate is 0%.
Tandem Mass Spectrometry (MS/MS) technology
routinely screens for several classes of metabolic
disorders like fatty acid oxidation, amino acid and
organic acid disorders all from one small disc of
dried blood in a single analytic run. Because it is
much more sensitive, specific, reliable and
comprehensive than traditional assays it has found
widespread use in newborn screening programs
around the world. It has replaced most of the oneanalysis, one-metabolite, one-disease classic
screening techniques with one-analysis, multiplemetabolites, many-diseases approach. The
conventional approach of first describing a disease
and then noting which metabolites are increased
has given way to the reverse approach which first
measures a large number of metabolically
important analytes from a routine blood sample
collected during the newborn period. Then, if
certain individual analytes or multi-analytes and
analyte ratios are elevated or decreased outside of
normal ranges, the software pinpoints the exact
metabolic disorder. The distinct benefit of early
routine screening is that the pre-symptomatic
detection of a metabolic disorder allows for
corresponding early treatment which increases the
likelihood of excellent outcomes. Treatment for
the different classes of metabolic disorders can be
in the form of dietary modification or special
formulas, vitamin or L-carnitine supplementation
or simple avoidance of certain foods, drugs and
chemicals for the affected individuals. The
undiagnosed or untreated outcome for those
afflicted with a metabolic disorder is very severe,
ranging from physical disability, to mental
retardation or sudden death. Once the symptoms
of metabolic disease manifest, it is often too late
for treatment to have a good outcome. Thus,
newborn screening is best performed 1- 14 days
after birth to have an optimal outcome.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-41.
Diagnosis of Aminoacidurias by HPLC: A Few Interesting Cases
Dr. Kannan Vaidyanathan
Clinical Assistant Professor, Dept of Biochemistry and Head, Metabolic Disorders Laboratory, Amrita
School of Medicine, Kochi, Kerala, INDIA – 682 041, Ph No: 0484-2858394;
Email – [email protected], [email protected]
Objectives: Aminoacidurias are one of the oldest
known classes among the various inborn errors
of metabolism. Using the technique of HPLC, we
wanted to detect the common aminoacidurias in
our population.
Methods: We have used high performance liquid
chromatography (HPLC) for the detection of
aminoacidurias in 350 consecutive clinically
suspected cases over a period of two and a half
years from November 2006 – April 2009. The
advantages of the method include – 1. Speed –
The entire analysis can be completed in 30
minutes, 2. Sensitivity – Sensitivity is very high,
and 3. Reproducibility. Cases were suspected for
aminoacidurias based on clinical presentation and
were from all parts of Kerala. Age range was 0 –
12 years.
hyper phenylalaninemia), tyrosinemia, maple
syrup urine disease and nonketotic
hyperglycinemia. We have detected 12 cases of
maple syrup urine disease, one case of isovaleric
aciduria, 2 cases of phenylketonuria, two cases of
nonketotic hyperglycinemia and 5 cases of
hypertyrosinemia. In addition, we have seen 56
cases with mild hyperglycinemia, and 40 cases
with mild hyperalaninemia. Other cases detected
include hypermethioninemia – 5, hyperprolinemia – 17,
hyperhistidinemia – 8 and hyperlysinemia – 2.
Conclusions: The incidence of aminoacidurias like
maple syrup urine disease is very high. Other
disorders including hyperphenylalaninemia,
tyrosinemia and nonketotic hyperglycinemia were
also detected. Early detection of these cases is
Results: We have obtained a wide range of cases possible if newborn screening is done. Therefore
of which some will be discussed. These include there is increased need for newborn screening
hyperphenyl alaninemia (PKU and non-PKU program in our country.
IL-42.
Specific Plant-Derived Products with Relevance to Clinical Medicine
P.G Latha
Tropical Botanic Garden and Research Institute, Palode, Thiruvananthapuram-695562
Medicinal plants have been a major source of
therapeutics since time immemorial. They are
therefore an important commodity item of
international trade and commerce. Many of them
are sources of clinically useful prescription drugs,
being used in modern systems of medicine.
Quinine extracted from the Cinchona tree
(Cinchona pubescens) (Rubiaceae) and artemesin
extracted from the Chinese medicinal plant,
80
Artemisia annua (Asteraceae) are examples of
extremely important drugs obtained from
medicinal plants. The use of artemesin in the
treatment of chloroquine resistant malaria
particularly in Asia is well established. Atropha
belladonna (Solanaceae)is the source of the CNS
stimulant, Atrophine.Allium sativum (Liliaceae)”Vellulli”is the garlic which prevents
arterosclerosis in blood vessels.Aloe vera
Indian Journal of Clinical Biochemistry Supplement, 2009/24
(Liliaceae) – “Kattarvazha”,of which the sap of
the cut fleshy leaves forms Aloevera gel , used
externally for burns. Cassia aungustifolia (Senna)
is a stimulating laxative. Curcuma longa
(Zingiberaceae)-the Turmeric or “Manjal” is
clinically used against dyspepsia and flatulence,
duodenal ulcers and stiffness of joints.Euphoria
hirta (Euphorbiaceae)- “Nilapala” is used
clinically to control amoebic bloody diarrhoea .
Reserpine from Rauwolfia serpentina
(Apocyanaceae) is used to reduce blood
pressure.Both experimental and clinical data
support use of ginger (Zingiber officinaleZingiberaceae ) for nausea , vomiting and digestive
problems.Vincristine and Vinblastine, known for
their anticancer property are obtained from
Catharanthus roseus. Berberine from Berberis
aristata, Coscinium fenestratum and Tinospora
cordifolia are used as febrifuge and against
gastritis.Xanthotoxin from Ammi majus and
Heracleum candidans is used against gout and
leucoderma. Podophyllotoxins from Podophyllum
hexandrum are effective against cancer. Morphine
and codeine from Papaver somniferum are used
as sedatives and analgesics.Psoralen from Psoralea
corylifolia is used against leucoderma. Hyosine
and hyosyamine from Hyosyamus niger and
Datura strammonium , provide sedatives and
antispasmodics. In the present lecture, an overview
of the specific plant derived and therapeutically
significant herbal products will be presented. The
important indigenous plants with significant
research leads leading to drug development will
also be highlighted.
IL-43.
Natural Products and Therapeutic Strategies: A Mechanistic Approach
Bipin Nair
Professor and Dean, Amrita School of Biotechnology, Amrita University, Amritapuri, Kollam,
Kerala, 690525, India. Tel: +91 0476 2896777,Email: [email protected]
Natural products of plant, microbial or animal origin have for long, been used in the treatment of
human diseases. As such, natural products still
offer unmatched structural diversity, especially as
new environmental niches are explored. Our studies have focused on attempting to understand the
mechanisms involved in enhancing the rate of
wound healing and the role of natural product extracts in this process. In particular, information
on the role of Matrix Metalloproteinases (MMPs)
in wound healing is scanty. Our investigation into
the regulation of MMPs by natural product extracts
has yielded interesting information. Increasing
our basic knowledge of the mechanisms involved
in the process of wound healing and the strategies
for pharmaceutical intervention may ultimately
help clinicians to identify and proactively intervene, in an effort to prevent normal wounds from
becoming chronic. This may also help to prevent
the high prevalence of morbidity associated with
this significant health problem.
IL-44.
ABC of Monoclonal Gammapathy and its Indian Scenario
T.Malati
Senior Prof & Head, Department of Biochemistry, Nizam’s Institute of Medical Sciences,
Punjagutta, Hyderabad 500082, AP . Email: [email protected]
The neoplastic proliferation of one and rarely two
specific clones of b cells / plasma cells results in
amplification of a large number of such clones
which produce a single type of immunoglobulin
81
Indian Journal of Clinical Biochemistry Supplement, 2009/24
molecule of homogeneous character, belonging to
one of the five classes of immunoglobulins
consisting of one type of two heavy and two light
chains. Apitz (1940) for the first time used the
term ‘paraproteins’ to denote proteins produced
by myeloma cells. The term now stands for
‘monoclonal’ and is coupled with globulin, peak,
spike, component etc. Multiple myeloma, arising
in the marrow of bone, is a predominant plasma
cell neoplasm belonging to the broad group of
monoclonal gammapathy. These primary bone
tumors comprise approximately 35% to 43% of
total hematological malignancies. Bone pain,
pathological fractures anemia, renal failure and
neurological manifestations are the main
symptoms associated with monoclonal
gammapathy. The presentation will highlight 1) the
methodology used for the diagnosis of monoclonal
gammapathy 2. Changes in biochemical analytes
occurring as a cause or effect of neoplastic
proliferation of plasma cells 3) role of ‘m’ protein,
b2 microglobulin and serum c-telopeptide as tumor
markers individually or in combination in
diagnosis, assessing efficacy of any treatment
modality (chemotherapy, radiation therapy,
antiresorptive therapy) predicting early recurrence,
assessing status of regression, analyzing
progression of disease and finally predicting
prognosis 4) the efficacy of urinary c- telopeptides
in evaluating and monitoring the bone resorption
process.
Il-45.
The Clinical Significance of Microalbuminuria
T.Malati
Senior Prof & Head, Department of Biochemistry, Nizam’s Institute of Medical Sciences
Punjagutta, Hyderabad 500082, AP; [email protected]
Microalbuminuria is associated with adverse
health outcomes in adults. An alarming and steady
increase of diabetics globally warrants the regular screening for microalbuminuria to identify
nephropathy at an early stage during the course
of disease in order to initiate timely intervention.
Diabetic nephropathy and end stage renal disease
(esrd) in india are emerging public health problems and therefore pose real challenge to health
care professionals. Diabetic nephropathy accounts
for nearly 11% deaths in patients of type 2 diabetes. Progression of nephropathy in diabetes patients is the single most common cause of end
stage renal disease (esrd) world wide. An early
detection and proper management of the disease
is therefore essential to prevent the morbidity and
mortality caused by disease. The course of diabetic nephropathy is characterized by urinary albumin excretion (uae) and glomerular filtration
rate (gfr). The association of glycemic control
with microalbuminuria has been established by
various studies. Improving glycemic control, aggressive anti hypertensive treatment and the use
82
of ace inhibitors definitely help in reducing the
rate of progression of nephropathy in type1 as well
as in type2 diabetic patients. Few studies support
the concept that microalbuminuria is not predictive of diabetic nephropathy, but rather is an earlier point in the identification of diabetic nephropathy. The importance of measuring
microalbuminuria is well established however controversies still exists regarding the type of urine
specimen to be used for detecting early renal impairment in diabetic patients. The clinical significance of microalbuminuria in non diabetic population is not fully clear. The microalbuminuria is
also detected in cases of essential hypertension,
systemic lupus erythmatosis etc. The other factors
which are associated with microalbuminuria are
alcohol intake, foot ulcers and smoking. The
awareness regarding the need for regular monitoring of albuminuria and proteinuria is less among
health care professionals in developing countries
like india. Screening for complication is particularly difficult at the primary care level due to lack
of resources, time and training of health professionals.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-46.
Biochemical Changes in Mountain Sickness
Savitha Nagabhushan, Thuppil Venkatesh, Vidyasagar Casikar2 E Mujica , J. Aliaga, N.Lopez,
C.Smith, F. Bartholomew and M.Mongelli
Traditionally mountain sickness has been regarded
as a dysfunction of respiratory physiology. We
have approached this problem differently based
on our experience during high altitude trekking.
1. We found significant drop in the cerebral blood
flow. This was absent among the Sadhus who were
practising Pranayama. We looked at the influence
of olfactory system on mountain sickness Albino
rats whose olfactory lobes were removed were
subjected to high altitude states under laboratory
conditions Blood and urine samples were
collected at various stages to measure biochemical
parameters. Results suggested that the olfactory
system regulated the pituitary function. High
altitude sickness is primarily a neurological
dysfunction. Olfactory system regulates
physiology at high altitude through its connections
with the median fore brain bundle.
Hypothalamus-pituitary-Adrenal axis is
influenced by the olfactory system through this
pathway. 2. Andean Indians have used coca leaves
(Erythroxylon coca and related species) for
centuries to enhance physical performance.. . The
benefits and disadvantages of using coca leaf have
been a subject of many political debates. The aim
of this study was to investigate the effects of
chewing coca leaves on biochemical and
physiological
parameters.
Cutaneous
microdialysis catheters were used to estimate
systemic biochemical changes. We subjected 10
healthy adult males (local residents) in Cajamarca
(Peru, altitude 2700 m) to a standardised exercise
routine on a stationary cycle ergometer. The blood
pressure, oxygen saturation (digital), pulse, VO2
max and ECG (Holter monitor) were recorded
before the exercise. Cutaneous microdialysis
catheters were introduced in the forearm. . The
subjects were given to chew 8 g of coca leaves
with a small amount of lime. They were then
placed on the cycle ergometer for 20 minutes.
Blood pressure, oxygen saturation, pulse, ECG and
VO2 max were recorded. Pyruvate, glucose,
lactate, glycerol and glutamate levels were
estimated. These results suggest that coca leaves
have blocked the glycolytic pathway of glucose
oxidation resulting in accumulation of glucose and
pyruvate. The energy requirement for exercise is
being met with beta-oxidation of fatty acids. The
glycerol released was also getting accumulated
since its pathway for oxidation was blocked. These
experimental findings suggest that chewing coca
leaves is beneficial during exercise and that the
effects are felt over a prolonged period of sustained
physical activity. The clinical significance of these
biochemical changes will be discussed.
IL-47.
The High Altitude Adaptation Formula
GR Zubieta-Calleja, P.E. Paulev, L Zubieta-Calleja & G Zubieta-Castillo
High Altitude Pathology Institute (IPPA) & Zubieta University, La Paz, Bolivia.
[email protected], www.altitudeclinic.com
We have previously determined that a full
adaptation to high altitude hypoxia is achieved
when the hematocrit reaches a plateau
corresponding to the normal level at that specific
altitude. Adaptation from the hematocrit point of
view, is defined as having three stages: 1) Acute,
first 72 hours, where Acute mountain sickness
(AMS), high altitude pulmonary edema (HAPE)
83
Indian Journal of Clinical Biochemistry Supplement, 2009/24
and high altitude cerebral edema (HACE) can
occur 2) Subacute, from 72 hours until the slope
of increase of the hematocrit is 0, where high
altitude subacute heart disease (HAHD) can occur
and 3) Chronic, where the plateau of hematocrit
level begins and where the normal residents
achieve their optimal hematocrit. In this third stage
chronic mountain sickness (CMS) subjects
(polyerythrocythemic patients) present an elevated
hematocrit, above that of normal individuals, for
the same altitude, due to a spectrum of medical
conditions originated fundamentally by cardiopulmonary deficiencies, often un-noticed at sea
level. Adaptation is altitude and time dependent
following the equation:
Time
Altitude
For a fixed altitude the only variable that changes
is Time. Hence the formula becomes a linear
relation such that:
Adaptation in days = Altitude in Km * 11.4.
This simplification is made for easy interpretation
only, as the true equation is quite complex and
follows the exponential change in barometric
pressure. Furthermore, for constantly changing
altitudes such as in mountain climbing, this
formula cannot be used in its simple form. This
formula is again analyzed in an attempt to achieve
a more precise focus.
Adaptation =
IL-48.
Do Over 200 Million Healthy Altitude Residents Really Suffer From Chronic AcidBase Disorders?
Gustavo Zubieta-Calleja (Jr), Gustavo Zubieta-Castillo (Sr), and Poul-Erik Paulev
High Altitude Pathology Institute, La Paz, Bolivia. [email protected]
As the oxygen tension in the inspired air (PIO2)
falls with increasing altitude in normal subjects,
hyperventilation ensues. This acute respiratory
alkalosis is compensated by increased renal
excretion of bicarbonate returning the pH back to
normal. The status is called totally compensated
respiratory alkalosis or chronic hypocapnia. It
seems to be a contradiction that so many normal
people should live their whole lives as acid-base
patients. In 1865 blood gas analyses performed at
3510 m, the PaCO2 (arterial carbon dioxide
tension +-SEM) = 29.4+-0.16 mmHg and pH =
7.40+-0.005. Base excess, calculated with the Van
Slyke sea level equation is - 5 mM (milliMolar or
mmol/L) as an average, suggesting chronic
hypocapnia. Consequently, the Van Slyke sea level
equation for the calculation of base excess must
be adapted to altitude and should be zero. “Base
excess” is misleading, since the essential variable
is not a base and in reality not always an excess
(or deficit). The essential concept is the titratable
hydrogen ion. We have modified Siggaard84
Andersen´s term “concentration of titratable
hydrogen ion” to “Titratable Hydrogen Ion
concentration Difference from normal”, THID
now used, instead of base excess. THID is ideally
determined by titration to a pH of 7.40 at a PaCO2
of 5.33 kPa (40 mmHg) at sea level, oxygen
saturated and at a blood temperature of 37oC. The
THID in vivo is independent of PaCO2, since any
change of PaCO2 implies opposite molar changes
of the bicarbonate and the non-carbonic buffer
concentrations. Consequently, there is no change
in THID, so the value is constant (normally equal
to zero) during acute changes in PaCO2 by hyperor hypoventilation. The buffer capacity of the
carbon dioxide – bicarbonate buffer is high, since
respiratory elimination of CO2 and bicarbonate
excretion of the kidneys rapidly maintains PaCO2.
We have introduced a modified Van Slyke equation
for high altitude (1). Since our Van Slyke equations
operate with normal mean values for PaCO2 at the
actual altitude, a calculation of THID will always
result in normal values - that is zero.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Reference: 1. Paulev P E, Zubieta-Calleja G R.
Essentials in the diagnosis of acid-base disorders
and their high altitude application. J Physiol and
Pharmacol 56, Suppl 4, 155-170, 2005.
IL-49.
The Ventilatory Hyperoxic Shunt Test at 3510 m. of altitude
G Zubieta-Castillo, L. Zubieta-Calleja, and GR Zubieta-Calleja, MD
High Altitude Pathology Institute(IPPA),ZubietaUniversity,La Paz, Bolivia. [email protected],
www.altitudeclinic.com
We use a new method to test pulmonary shunt by
hyperoxia at high altitude. The subject is tested
first breathing ambient air in the seated position.
Using a face mask, ventilation, ETO2, ETCO2,
ECG, pulse oximetry and blood pressure are
measured. An arterial blood sample is taken from
the radial artery. The whole procedure is repeated
with the subject breathing 89% oxygen during 6
minutes. A 100 % O2 could be used, but it was
not available. This technique allows for precise
measurements that provide a clear picture of
cardio-respiratory parameters. Furthermore it
allows the possibility of observing when there is
an equilibration of the PIO2 as it is observed on a
breath by breath basis in the same wave that the
ETO2 is observed. The average PIO2 was 421.7
mmHg. For 3510 m, the altitude of our Laboratory,
the test performed in 14 normal subjects (mean ±
SD) using
This tests permits the operator to observe when
the pio2 reaches the maximum level thereby
making the precise observation of shunt,
irrespective of uneven ventilation that can delay
such equilibration of inspired gases. The intrapulmonary shunts are essential for evaluation of
patients with chronic mountain sickness at high
altitude.
t-students reports:
SpO2 in % VE BTPS
ETCO2
mmHg
ETO2
mmHg
66.42
± 4.05
Ambient Air
91.56
± 1.45
9.19
± 2.3
28.05
± 1.9
89% O2
98.15
± 0.73
<0.0001
8.26
± 2.06
NS
26.17
± 2.2
<0.0001
p=
PaO2
mmHg
PaCO2
mmHg
pH
59.3
± 5.92
27.7
± 3.72
7.43
± 0.03
337.59
237
± 14.7
± 25.8
<0.0001 <0.0001
27.25
± 3.6
NS
7.46
± 0.06
NS
IL-50.
Get Together on Biochemistry - An Experimental Teaching
Dr.W.Ebenezer William
Professor & Head, Department of Biochemistry, SRM Medical College Hospital & Research Centre,
Kattankulathur, Tamil Nadu – 603 203 E.Mail: [email protected]
This is to share my experiences of experimental
teaching of Biochemistry by programming a Quiz
in Get-together on Biochemical topics which are
minced with extra curricular activities like drawing
rangoli on biochemical structures, group singing
on the themes of ketogenesis, B-complex, TCA
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
cycle and Hemoglobin biosynthesis along with
light music songs, mimicry, skits and instrumental
music by the talented first year Medical & Para
medical students of various Medical Colleges of
Tamil Nadu. The quiz programme had no quiz
master; instead, the participating teams quizzed
each other. The team answering correctly went on
to question the next team and so on. This format
was thoroughly enjoyed by the participants and
spectators. During the rehearsal the interaction of
the students with the Faculty which gives an
extraordinary interest in the subject –
Biochemistry and also during the “Get together”
the students will experience their own leadership
qualities, boldness to face the people by showing
their academic interest and under hidden talents
since the programme is being organized by the
students, for the students and to the students. While
senior Faculty of various Clinical and Para clinical
departments and administrators are felicitating it
motivates the students mind to acquire knowledge
on medicine (Biochemistry) through the Inter –
disciplinary approach. All these efforts are to make
the “Lighter side of the Biochemistry to become a
Brighter one”
IL-51.
The Role of Clinical Chemist in the Management of PatientRay U
Department of Pathology, Royal Hobart Hospital, University of Tasmania, Australia.
Clinical chemistry tests make up 75-90% of the
laboratory tests request laboratories around the
globe receive from the clinicians and others for
the clinical management of health and diseases
of individuals in the society. As the advancement
in the field of medicine progresses so is the advancement in the technology related to the field
of laboratory medicine. Many time consuming and
complex tests are now done easily and within an
acceptable time limit by the instruments. Many
of us believe or try to consider that the need of
clinical chemists is diminishing as the clinicians
can read the tests and move accordingly for the
appropriate clinical outcome. Patients in the hospital system are largely managed clinically by the
junior doctors and in studies done globally found
that laboratory tests are ordered at random, very
few of them understand the implications and many
of them do not even know how to interpret. In a
real time scenario a proactive clinical chemist addressing these issues can substantially contribute
to the delivery of cost effective health service to
the community by using his/her knowledge and
expertise judiciously during the liaison with the
clinicians responsible for the patients’ management
by adding or restricting the tests repertoire to help
in the diagnosis, prognosis, and monitoring of the
patients. If critically assessed a wise and proactive clinical chemist can take a leading role in the
safe and effective delivery of the health service to
the ailing subjects following the principles of evidence based practice of medicine.
IL-52.
Maturity Onset Diabetes in the Young (MODY)
V.Parameswaran, A.Duffield, S.Powell and J.Burgess
Diabetes and Endocrinology Services, Royal Hobart Hospital, Tasmania, Australia
Maturity onset diabetes of the young (MODY), characterised by lack of insulin dependence at onusually diagnosed before the age of 25, is a ge- set, absence of ketosis and is autosomal dominant
netically heterogeneous form of diabetes. It is in transmission. Approximately 2% - 5% of pa86
Indian Journal of Clinical Biochemistry Supplement, 2009/24
tients with type 2 diabetes fall into the MODY
category. Six genetic forms of MODY have been
recognised. MODY-3 due to hepatocyte nuclear
factor 1a (HNF 1a) is the most common amongst
various ethnic populations with a prevalence rate
of 21% - 64% while MODY-2 caused by Glucokinase gene defect being the second most common
accounts for ~14%. The varied presentation of
MODY poses a problem in the biochemical diagnosis of this condition. Understanding of the criteria for differential diagnosis of Type 1 & 2 diabetes with the MODY type is important as a single
clinical criterion may not apply to clearly delineate the presentation of this condition. The underlying pathogenesis and diagnostic criteria with
examples will be presented
IL-53.
Post -transplant Diabetes Mellitus Following Immunosuppressive Therapy
Dr. Pragna Rao
Professor and Head, Department of Biochemistry, Kamineni Institute of Medical Sciences , Narketpaly,
Andhra Pradesh
Diabetes mellitus is a metabolic disorder that is
also a recognized complication of organ
transplantation. Post-transplant diabetes mellitus
(PTDM) is a form of type 2 diabetes mellitus,
which is thought to develop in response to a
relative insulin deficiency resulting from increased
insulin resistance or impaired insulin production,
or a combination of both. Transplant recipients are
at a particularly high risk of developing PTDM as
a consequence of factors additional to those that
affect the general population, including the
immunosuppressive agents used in transplant
management protocols. PTDM is not a separate
entity, but a symptom of an underlying metabolic
disorder,
which
is
uncovered
by
immunosuppression. While both tacrolimus (TAC)
and ciclosporin (CsA) are known to be associated
with PTDM, the mechanisms underlying this
metabolic disturbance and the relative contribution
of concomitant corticosteroids have been unclear
There is no single, clear definition of PTDM.
Depending on the definition, incidences of
approximately 5-40% have been reported in
patients after renal transplantation. Some
investigators only include those patients using
insulin treatment for a period of at least 30 days ,
while others also include patients taking oral
glucose-lowering drugs (need for drug treatment).
Several risk factors for the occurrence of PTDM
have been described. These include genetic factors,
race, family history of diabetes, older age, obesity,
and the use of calcineurin inhibitors and steroids.
Steroids disturb glucose tolerance by enhancing
insulin resistance. They play a significant role in
the development of PTDM. The mechanism by
which calcineurin inhibitors such as cyclosporine
and tacrolimus may cause impaired glucose
metabolism has not been completely elucidated.
CsA also has an effect on glucose metabolism. In
vitro experiments have shown that CsA dosedependently inhibited insulin secretion . In the
initial report comparing CsA and TAC, it was
mentioned that the incidence of PTDM was
comparable . The pivotal trials, however, showed
significantly higher incidences with TAC . A defect
in insulin synthesis as a result of an mRNA
transcriptional defect was found to be dependent
on duration of exposure to TAC in rats. In clinical
studies, an increase in insulin resistance was
suggested as an additional mechanism underlying
the development of PTDM. Because both
hyperinsulinemia and hyperglycemia are known
to promote atherosclerosis, PTDM probably
contributes to the high prevalence of death from
cardiovascular disease seen in this population.
Furthermore, the preponderance of infections
associated with diabetes mellitus is likely to
increase the risk for sepsis in the transplant
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
population. PTDM is responsible for an increased
incidence of graft failure ; however, to what extent
this is caused by the development of diabetic
nephropathy is not clear Hyperglycemia itself may
upregulate the synthesis of such soluble mediators
of fibrosis in the kidney as transforming growth
factor-ß, which may be important in promoting
mesangial matrix expansion and mesangial cell
hyperplasia. These growth factors are likely to have
a role in the development of chronic allograft
nephropathy, which was the predominant cause of
graft loss in the observational studies of graft
outcome with PTDM.
IL-54.
Point-of- Care testing (POCT)
C.V.Anand
Professor and Head, Dept of Biochemistry, PSG Institute of Medical Sciences and Research,
Coimbatore-641004.
POCT, defined as diagnostic testing at or near the
site of patient care, is to facilitate rapid diagnosis
and faster treatment decisions to improve patient
care and reduce morbidity and mortality. POCT
impacts every branch of the healthcare system.
The devices should be simple to use, robust in
terms of storage and usage and, produce results
that are concordant with the results of the central
laboratory. The results should be consistent with
clinical need and, most importantly, they should
be available without any delay. The POCT
equipment employ different analytical principlesfor example, reflectance, lateral-flow or flowthrough immunoassays, electrochemistry, light
scattering,
immunoturbidimetry,
spectrophotometry, fluorescence and electrical
impedance, to name a few. The most frequently
used equipment is the glucometer, which was
introduced more than three decades ago. POCT
has contributed immensely to the diagnosis of
sepsis, acute coronary syndrome, stroke, GI
bleeding, kidney failure and DKA. Now a whole
gamut of tests are performed using POCT
equipment; cardiac markers- troponins, brain
natriuretic peptide (BNP), NT-pro BNP, blood
gases, plasma lipids, glycated hemoglobin etc. The
major argument against POCT is that, it is carried
out by personnel with no formal training in
laboratory technology. Needless to say that, issues
such as calibration, quality control and
documentation take the back seat. Added to these
are the high costs and poor comparability with
central laboratory results. The advantages of POCT
are reduced TAT, and plausible improved patient
management. POCT has also been shown to lead
to shorter hospital stay and improved health
outcomes. To illustrate, POCT for heart type fatty
acid binding protein (H-FABP), an early marker
of acute myocardial infarction has been recently
introduced, providing a significant benefit for
patients at small rural hospitals.
IL-55.
Protein Misfolding Diseases
Dr.Usha Anand
Professor, Department of Biochemistry, PSG Institute of Medical Sciences & Research, Coimbatore-641 004.
Protein misfolding / conformational diseases diverse disorders which have a common feature at
consist of a group of clinically and pathologically the molecular level; the presence of a protein that
88
Indian Journal of Clinical Biochemistry Supplement, 2009/24
acquires a non-native, atypical conformation.
Based on the causative factor, protein misfolding
diseases could be broadly classified into three
categories. a) Reduction in folding efficiency
leading to a fall in the levels of the protein
involved. Cystic fibrosis is caused by defects in
the cystic fibrosis transmembrane conductance
regulator (chloride channel). The misfolded
protein is tagged by ubiquitin and degraded
resulting in a decrease in the levels of this transmembrane protein. b) Diseases in which
misfolding of a given protein results in improper
trafficking. In early-onset emphysema, alpha-1antitrypsin molecules which are formed in the liver
undergo polymerization. They are retained in the
liver and will not reach the lungs. c) Diseases
associated with aggregation of misfolded proteins.
In Alzheimer’s disease accumulation of a betaamyloid peptide leads to the formation of extracellular plaques. A second protein known as ‘tau
protein’ is responsible for neurofibrillary tangles.
AD primarily affects neurons of the hippocampus
and basal fore-brain leading to brain shrinkage and
loss of memory and intellect. Transmissible
spongiform encephalopathies: (Example:
Crutzfeldt-Jakob disease) The misfolding is
initiated and propagated by an abnormal protein
designated as PrPsc (prion protein scrapie), a form
which has extensive beta pleated structure.
Huntington’s disease in which the ‘Huntington
protein’ with polyglutamine repeats have been
demonstrated. Amyptropic lateral sclerosis caused
by mutations in the anti-oxidant enzyme
superoxide-dismutase. Non-functional SOD
aggregates cause this disease. With intense
research in this field the number of diseases
associated with protein misfolding is on the rise.
A thorough understanding of the mechanisms
involved would go a long way in instituting
effective therapeutic measures.
IL-56.
Obesity – A Global Dilemma
V.Parameswaran, L.Blackwell, L.Diggle, J.Burgess and R.McCallum
Diabetes & Endocrinology Services, Royal Hobart Hospital, Tasmania, Australia
Obesity, a leading cause of morbidity and mortality, is associated with a spectrum of diseases particularly diabetes, cardiovascular disease, cancer,
osteoarthritis and breathing disorders. An obese
person runs a 50% increased risk of premature
death than someone of normal weight. Genetic
factors and also environmental factors are involved
in the development of obesity. Around seven million (~ 30%) Australians are in the obese category
and this trend is also reflected globally. Along with
other conditions that are related to obesity, the risk
of developing insulin resistance and diabetes is
also increasing rapidly. Research in finding treat-
ment and effective management is being constantly
sought and trialled to try and mitigate the clinical
effects of obesity. Common approaches include
diet, exercise and lifestyle modifications. Recent
approaches have focussed on newer drugs as also
the additional option of surgery in the management of obesity in those where it is refractory by
other means. The need for appropriate screening
to reduce the risk of developing diabetes is important. Some of these strategies along with dietary
and lifestyle change programs, new diabetes medical treatments, lap-band surgery will be presented
and discussed.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-57.
Scholarly Communication: Writing a Research Paper for a Peer-Reviewed
Publication
R S Jayasomu
National Institute of Science Communication and Information Resources (CSIR), New Delhi
Communicating science is as important as doing
science. Knowledge is perhaps the only commodity apart from love and peace that grows when
shared. Science grew effectively only after it was
communicated, shared, and discussed upon. Science writing is not storey writing. It has set rules
and regulations, format and style depending on
what you write about, and to whom you address.
Broadly, science writing can be classified into
popular science writing, writing for encyclopedia, and research communication. Communicating research needs to be focused as it would address specific audience, the scholars. Conventionally, basic units of a research publication include
Introduction, Materials and Methods, Results,
Discussion, Conclusion, Acknowledgement and
References. Data are given either in tables or expressed graphically through illustrations. Abstract
and keywords are given in a separate sheet, pref-
erably in the beginning following the covering letter and declaration. Generally, first page of a manuscript should have the Title, name(s) of author(s),
their affiliations, contact address of author for correspondence, abbreviations, if any, and a short title.
Tables and illustrations are given separately after
references. Care should be taken that the table data
are not repeated as illustrations. Legends or captions of illustrations are to be typed separately in a
page.
Once the data are ready after your experiments, it
is necessary to find an appropriate journal for communicating the results of your research work. Papers published in non-core journals seldom get
their due citation. In the present paper, I intend to
share my knowledge gained during the last two
decades in this profession of science editing on
how to write a research paper
IL-58
Urine Albumin: Standardisation and Reporting Issues.
H. D. Martin
Gribbles Pathology, 1 Goodwood Rd, Wayville, SA 5034, Australia
Urine albumin is well established as an early marker
for nephropathy in diabetic subjects. More recently it
has also been identified as an important prognostic
marker in hypertension and cardiovascular disease.
Despite the literature supporting clinical utility there
is evidence that clinicians do not often request urine
albumin, particularly in their non-diabetic patients.
Furthermore, when they do make the request, they find
interpretation confusing and adherence to guidelines
is poor. Currently there is no reference system for the
90
measurement of urine albumin: in particular the
measurand is not defined, there is no reference material and although the manufacturers of the majority of
methods in routine laboratory use the same calibrator
source, it is a serum based material and individual
preparations are not standardised. Despite this, the
analytical variation represents a small proportion of
the total error in urine albumin measurement. It is the
pre-analytical phase which contributes the major variation. Albumin excretion rate (AER) and albumin crea-
Indian Journal of Clinical Biochemistry Supplement, 2009/24
tinine ratios (ACR) vary substantially with collection
type and patient preparation. Daytime collections yield
significantly higher results than nightime collections.
Exercise, stress, posture, infection, hydration and blood
contamination can contribute to bias in both AER and
ACR. Creatinine variation will contribute significantly
to variation in ACR but reference ranges are not age/
gender/race specific. Decision points for urine albu-
min, AER and ACR in common use vary widely and
none has been clinically validated for the particular
method. The NKDEP/IFCC has a urine albumin working group that is collaborating with other professional
groups to work towards standardisation; in the meantime individual laboratories can play a crucial role in
educating health care providers.
IL-59
Molecular Mechanisms of Angiogenesis in Heart and Lung
Hari S. Sharma
Angiogenesis and Tissue Remodeling Group, VUMC, Amsterdam and Erasmus MC, Rotterdam,
The Netherlands
Right ventricular hypertrophy and failure are
common features in patients with tetraogy of Fallot
(TF). Myocardial angiogenic gene expression
profile was examined in patients with right
ventricular hypertrophy and failure in order to
assess myocardial vascularisation. DNA
microarray analysis on right ventricular biopsies
from TF-patients operated for primary corrective
surgery (TF-1, n=8, mean age 0.5 year) and age
matched controls was validated by Northern
hybridization and RT-PCR. Employing
immunohistochemistry and video image analysis
expression of vascular endothelial growth factor
(VEGF), vascular density (by a-SMA and CD31
staining) and myocyte cross sectional area
(Gomori’s reticuline staining) were assessed in
TF-1 and adult patients (TF-2, n=8, mean age 30
years) who underwent surgery for pulmonary
regurgitation and compared the data with age
matched controls. DNA microarray analysis
revealed altered expression pattern for several
genes including angiogenic factors, VEGF, flt-1,
flk-1 angiopoietin-2, FGF-2, FGF-R1, PDGF-A,
whereas, flt-4, Tie, TGF-b, TGF-b3R showed
decreased expression in TF patients. Northern blot
analysis verified VEGF expression whereas, flk1 expression remained unaltered in both TF-1 and
TF-2 patients. VEGF staining in cardiomyocytes
was increased in TF-1 as compared to TF-2. Video
image analysis revealed enhanced vascular density
with unchanged wall thickness and enlarged
myocyte cross sectional area in both TF-1 and TF2 as compared to respective age matched controls.
Right ventricular hypertrophy is associated with
an altered gene profile for a number of genes where
the VEGF/VEGF-R system plays an important role
in enhanced myocardial angiogenesis with limited
vascular remodeling.
In another set of experiments
Mechanisms of angiogenesis were studied using
human Cell culture based in vitro models. We have
shown that different growth factors and cytokines
result in differential gene expression and secretion
of various proinflammatory cytokines and vascular
endothelial growth factor (VEGF), an angiogenic
molecule in cultured human ASM cells. To assess
the role of airway smooth muscle (ASM) in
bronchial angiogenesis and remodeling, we
investigated the production of VEGF in ASM cells
in relation to mediators of asthma, such as, IL-1b,
TNF-a, TGF-b, ANG II and ET-1. Time dependent
release of VEGF protein in the conditioned
medium was observed which in its turn induced
proliferation and growth of pulmonary artery
endothelial cells. We further investigated the
effects of nitric oxide (NO) pathway on the pro91
Indian Journal of Clinical Biochemistry Supplement, 2009/24
inflammatory cytokine; Interleukin-1b (IL-1b)
induced expression and secretion of VEGF and
PlGF. Serum deprived (for 48h) ASM cells were
stimulated with IL-1b (5 ng/ml), IL-1b + Nw-nitroL-arginine methyl ester (L-NAME), IL-1b + Larginin and IL-1b + L-NAME + L-arginine for 4
and 24 h. NO synthase inhibitor (L-NAME) was
used 1h prior to IL-1 incubation in all experiments.
IL-1b induced expression (1.8 fold vs control) of
VEGF mRNA (quantitative RT-PCR) was
attenuated by L-NAME and augmented by Larginine. L-NAME inhibited the secretion of
VEGF and PlGF in conditioned media of IL-1b
treated PASMC at 4 and 24 h, respectively. By
restoring NO pathway (L-arginine treatment) in
L-NAME treated cells led to elevated (2.2 fold)
expression of VEGF. Taken together, our findings
suggest that a cytokine cascade involving mainly
IL-6, IL-8 and VEGF operates in hyper contractile
human ASM cells where NO pathway may
modulate VEGF signaling during airway
inflammation and subsequently contributing to
bronchial angiogenesis and airway remodeling in
patients with asthma and COPD.
IL-60
The Pro-Inflammatory Role of Extracellular RNA in Arteriogenesis
Elisabeth Deindl
Walter-Brendel-Center for Experimental Medicine ; Ludwig-Maximilians-University Marchioninistr.
27 D-81377,Munich,Germany
The growth of pre-existing arteriolar anastomoses
to large conductance arteries (arteriogenesis) is
the most important tissue-, organ-, and often life
saving process after arterial occlusions. It can be
so efficient that occlusions of coronary, peripheral,
renal, and cerebral arteries may occur without
tissue loss and even without loss of function. The
initial trigger for the growth of those natural
bypasses is fluid shear stress activating the
endothelium surface, thereby leading to
modulation of processes controlling the
recruitment of circulating cells. The inflammatory
aspect of this activation is apparent by the
increased expression of ICAM-1 as well as of
MCP-1, a chemoattractant protein responsible for
the adhesion and migration of monocytes to the
endothelium. Recently, extracellular RNA was
described to act as “danger signal” and trigger
immune response. In order to investigate the
function of extracellular RNA in an animal model
of arteriogenesis, the right femoral artery of mice
was ligated and the left was sham operated.
Arterial growth was measured via Laser Doppler
Imaging (LDI) and quantified as relative perfusion
92
recovery (right/left) before and after surgery until
day 7. Treatment with RNase, but not with DNase,
immediately before occlusion of the artery until
day 7 significantly reduced the extent of
arteriogenesis (perfusion recovery in untreated or
DNase treated mice: 83%, in RNase treated mice
44%), suggesting that extracellular RNA plays a
role in the process of arteriogenesis. Accordingly,
in vitro studies confirmed that RNA acts as a
chemoattractant for monocytes. In an endothelial
cell monolayer the migration of monocytes was
increased by RNA to nearly the same extent as by
MCP-1. In addition, there was an increase in
adhesion of monocytes to microvascular
endothelial cells by RNA, but not by DNA. The
expression of ICAM-1 on endothelial cells was
increased by RNA and abolished in the presence
of RNase. Furthermore, RNA led to exocytosis of
pro-inflammatory factors like P-Selektin from
Weibel-Palade bodies. In summary, our data
indicate that extracellular RNA promotes the
process of arteriogenesis by immune-modulating
effects.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
IL-61
Pharmacogenomics: One Size Does Not Fit All
Dr. Amit Chakrabarti.
Professor of Pharmacology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim 737 102, India
Pharmacogenomics is the study of how an
individual’s genetic environment influences
response of drugs. It is thus an intersection of
pharmacology and genetics. Although the
knowledge that genes may influence action of
drugs was present since the 1930s, major advances
occurred only in the last couple of decades.
Fundamentally, pharmacogenomics conveys the
message that no two persons are similar with
respect to effect of drugs, because everyone has a
different genetic milieu. This essentially promises
that one day extremely safe drugs could be tailored
considering a person’s genetic constitution.
Therefore,
potential
benefits
of
pharmacogenomics include 1) synthesis of more
disease specific medicines, with less potential of
damaging healthy cells; 2) prescription of best
drugs for a particular patient considering genetic
constitution; 3) more appropriate dose titration of
medicines; 4) early screening for genetic diseases;
5) safer and cost-effective vaccines; 6) simpler
drug development process identifying subjects
with a particular genetic make up for a particular
drug; and 7) overall reduction in health care costs.
As of now pharmacogenomics is in limited clinical
use. Most prominent use is for identification of
variants of the cytochrome P450 enzyme system.
Before clinical trials investigators can detect if the
trial participant has a different form of P450
enzyme, which may reduce drug metabolism and
increase chance of adverse events.
Pharmacogenomics is in its infancy and has a
number of barriers to overcome before becoming
truly applicable in everyday clinical practice. Some
of the barriers to successful clinical translation are
1) large number of gene variations affecting drug
action; 2) drug choices are not sufficient to account
for all variations; 3) developing a number of drugs
to fit different genetic make ups is not a costeffective drug development option; 4) drug
prescription according to pharmacogenetic profile
will be a complex process involving further
diagnostic tests and intensive training for treatment
providers.
IL-62
Lead Not Safe in Environment
Dr. Krishnajyoti Goswami
Director, National Referral Centre for Lead Poisoning in India, West Bengal (NRCLPI, WB);
President, Association of Clinical Biochemists of India (ACBI); Professor of Biochemistry, Ramakrishna
Mission Seva Pratishthan; Vivekananda Institute of Medical Sciences; 99 Sarat Bose Road,
KOLKATA - 700 026. Email: [email protected] & [email protected]
Lead is one of the toxic heavy metals, which is environmental as well as health hazard, affecting
globally considered as the number one people of all age groups. It has deleterious effect
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
on all organs in the human body. Lead poisoning
is widely recognised as a major public health
problem all over the world.
Every moment, we are building a stock of Lead in
our body. Lead from our house paints, drinking
water, food staffs, glossy cosmetics accumulate
in our body creating a stock of unwanted toxic
chemical – Lead Poisoning, a “Silent Epidemic”.
The human body cannot process and expel lead.
Sustained and close contact can cause serious
damage to developing central nervous system and
brain that leads to a child performing poorly in
exams or having short attention spans. Adults who
are exposed to lead poisoning many find it difficult
to concentrate or remember things and feel pain
in muscles and joints.
Children and women are found most vulnerable
to lead poisoning (also known as saturnism,
plumbism, or painter’s colic). Lead may cause
irreversible neurological damage as well as renal
disease, cardiovascular effects, and reproductive
toxicity.
Lead level in blood exceeding 10 ug/dl (recently
2.0 ug/dl) is considered as unsafe, but studies
indicate that over 60% of children in India may
have more than this level in their blood.
Unlike other health hazards, lead poisoning is
100% preventable by early diagnosis and
prevention of exposure by awareness.
Paint manufacturers have the capability and
technology to phase out lead from their products.
But costs being an issue, companies complain that
making lead free products makes the product
expensive, and lowers their market share. It is
therefore, even more important to have mandatory
standards for all branded companies globally. The
environmental regulation should not be confined
to production but extended to products we use.
The awesome effect of the “silent epidemic” needs
to be understood and propagated to the mass for
their awareness and effective prevention - thus
“help yourself and others too”.
IL-63
Developments in the Biochemical Assessment of Renal Disease
David Torrens
Accurex Biomedical/ Genzyme Diagnostics
Chronic kidney disease is increasing throughout
the world, linked to an ageing population and an
increase in type 2 diabetes. Serum creatinine
measurement based on the Jaffe reaction has been
central to the assessment of renal function for
decades, despite a growing understanding of
interferences with the method. Manufacturers have
made attempts to reduce bilirubin and protein
94
interference and are introducing calibration
traceable to isotope dilution mass spectrometry.
Equations have been developed to convert
creatinine results into eGFR using factors known
to affect creatinine measurement. The four
parameter MDRD equation includes age, sex and
race; although the only race options are Caucasian
and Afro-Caribbean. There is now a more recent
Indian Journal of Clinical Biochemistry Supplement, 2009/24
CKD-EPI equation and a new Schwartz equation only applicable to patients over 18 years old and
for paediatric use.
makes assumptions about a standardised body type.
The IFCC Scientific Division and NKDEP
Laboratory Working Group called for more
specific creatinine methods to be adopted, and the
introduction of enzymatic creatinine methods has
effectively removed the major interferences seen
with the chemical Jaffe reaction.
The improved accuracy of enzymatic creatinine
has advantages in a number of patient groups. In
particular, for children and neonates where the
correction factors for protein interference are
inappropriate, enzymatic creatinine measurements
are required.
Also, eGFR is unreliable when greater than 60 mL/
min/1.73m2 and a single creatinine measurement
is insensitive to moderate reductions in GFR.
Cystatin C measurement overcomes many of these
problems. It is produced consistently and is freely
filtered at the glomerulus, not affected by age,
gender, muscle mass, nutritional status or
malignancy. Its use has been validated in
paediatrics, the elderly and in those with diabetes
and coronary heart disease. The potential for
detecting earlier stages of renal disease that may
However, there are fundamental problems with be more amenable to treatment is of particular
creatinine measurements. The MDRD formula is interest.
IL-64
ISO 15189 : 2007
Dr. Elizabeth A. Frank
Labotatory medicine and the clinical lab have oorder to give formal recognition that the laboraundergone many a changes in the last decade. tory is competent to carry out examinations based
Clinical Labs now play a pivotal role in diagnosis on ISO 15189:2007. Particular requiremment for
and management of disease. From being small quality and competence.ISO 15189 will be disinsignificant part of medicine the labs have cussed in detailed with the view to help labs to
emerged into being sophisticated and highly au- undersatand the standard and prepare the labs for
tomated aspiring to support the clinician. the need accreditation.
for quality in reporting and manageement is now
the need of the hour. Though India lacks regulation that makes accreditation mandatory. It is important for the Laboratories to recognize the need
for accreditation and the value it brings.
Accreditation is a peer-review process by which
an authoritative body ensures that laboratories
meet explicit quality management criteria in
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
ABSTRACTS OF PRESENTATIONS
Abstract No: 1.1
A Study on Free and Total Prostate Specific Antigen in Benign Prostatic Hyperplasia
(BPH) and Carcinoma Prostate
Dr. R. Lalitha
Associate Professor Biochemistry, Stanley Medical College, Chennai – 600001
Objective: The molecular forms of Prostate
Specific Antigen (PSA) are Free PSA (unbound)
and bound forms – PSA á (antichymotrypsin) and
PSA á 2 (macroglobulin). Studies established that,
in BPH more free form is present than CA Prostate.
This study aimed to evaluate free and total PSA
in BPH and CA prostate and the ratio between free
PSA to total PSA (which is % Free PSA) in
discriminating between these two diseases. Free
PSA and total PSA are correlated with, prostatic
volume, total acid phosphatase, prostatic acid
phosphatase, total PSA density and free PSA
density.
Methods: The study was carried out on 79
patients of age 50 and above. They constituted
40 normal, 24 BPH and 15 CA Prostate patients.
Serum total PSA and free PSA were estimated by
a microplate Enzyme immunometric assay (EIA).
Results: The two diseases were differentiated at
cut off level of 6 ng/ml (sensitivity 42%, specificity
88%) of total PSA, and 0.5 ng/ml of free PSA
(sensitivity 58%, specificity 88%). In, % free PSA.
A cut off level of 0.1 is established between
controls and prostate diseases, but a suitable cut
off for the 2 diseases was not established.
Conclusion: Free PSA, Total PSA, and % free
PSA increased in prostate cancer, but not in
controls. On contrary to the previous studies, there
was no difference in any of the three entities,
namely, total PSA, free PSA and % free PSA,
between the two diseases. Among the biochemical
parameters evaluated, total and prostatic acid
phosphatases are better indicators in differentiating
between BPH and CA Prostate in patients with
increased prostatic volume.
Abstract No: 1.2
Evaluation of Enzyme Markers in Carcinoma Cervix.
Dr.P.B.Desai and Dr.Chetana.K
Department of Biochemistry, KLE University’s J.N.Medical College.Belgaum.India,
Email: [email protected]
Objective: Cervical cancer is the second most
common cancer in women worldwide. In India
also it accounts for a quarter of the global burden
of cervical cancer. As there are very few studies
on enzyme markers in cervical cancer the present
96
study has been undertaken to assess the reliability
of some of the enzyme markers namely, serum
adenosine deaminase (ADA) and gamma glutamyl
transferase (GGT) which are inexpensive, analysed
by easy methods and may be used as supportive
Indian Journal of Clinical Biochemistry Supplement, 2009/24
parameters for diagnostic purpose and may add The mean serum Gamma glutamyl transferase
further for prognostic information.
level was 19.61 ± 5.80 U/L in controls whereas in
Methods: The present study comprised of 40
healthy females in the age group of 35-65 years
as controls and 40 clinically and
histopathologically confirmed patients of cervical
cancer of the same age group. Serum ADA was
estimated by Galanti and Giusti Method and
Serum GGT by Carboxy substrate method.
Results: In the present study, mean serum
adenosine deaminase level in controls was 20.81
± 5.97 U/L while in the patients of cervical cancer
56.45 ± 19 U/L. A highly significant increase in
serum ADA was observed in cervical cancer
patients as compared to controls (p value < 0.001).
cervical cancer patients 40.96 ± 8.45 U/L. A
significant increase in GGT was observed in
cervical cancer patients when compared to controls
(p-value < 0.001)
Conclusions: Present study suggests that serum
adenosine deaminase and gamma glutamyl
transferase may be used as supportive parameters
for diagnostic purpose and may add further for
prognostic information. These biochemical
parameters are inexpensive, rapid and can be easily
analysed in smaller laboratories which have not
exposed to any sophisticated technology.
Abstract No: 1.3
Serum Fluoride and Sialic Acid Levels in Osteosarcoma
R. Sandhu, Z. S. Kundu, S. Kharb and Harbans Lal
Postgraduate Institute of Medical Sciences, Rohtak (Haryana), Email: [email protected]
Objective: Osteosarcoma is a rare malignant bone
tumor, most commonly occurring in children and
young adults, presenting with painful swelling.
Various etiological factors include ionizing
radiation, family history of bone disorders and
cancer, chemicals such as fluoride, beryllium and
vinyl chloride, and viruses. Glycoproteins and
glycosamino-glycans are integral part of bone and
prolonged exposure to fluoride, for long duration,
has been shown to cause degradation of collagen
and ground substance in bones.
Methods: The present study was therefore
planned to analyze serum fluoride, sialic acid,
calcium, phosphorus, and alkaline phosphatase in
25 patients of osteosarcoma, and age and sex –
matched patients with bone-forming tumors other
than osteosarcoma, and a group of patients with
musculo-skeletal pain as controls. Fluoride was
estimated by ISE, and sialic acid by Warren’s
method. Mean serum fluoride concentration was
found to be significantly higher in patients with
osteosarcoma as compared to the other two groups.
Results: Mean serum fluoride concentration in
patients with other bone-forming tumors was
nearly 50% of the group of osteosarcoma, however,
it was significantly higher when compared with
group I. serum sialic acid concentration was found
to be significantly raised in patients with
osteosarcoma as well as in group with other boneforming tumors as compared to the controls.
Conclusion: Results suggest a role of fluoride in
the disease.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 1.4
Diagnosis of Breast Cancer by the Determination of Plasma Maspin Level
Karabi Ganguly (Bhattacharjee), G.V.Girish and Asru K. Sinha
Sinha Institute of Medical Science and Technology, 288 Kendua Main Road, Baishnabhghata, Garia,
Kolkata-700084, E mail- [email protected]
Objective: The occurrence of breast cancer in
women is one of the most common neoplastic
conditions. Unfortunately at present the diagnosis
of breast cancer by biopsy remains only option
for the confirmation of the condition. We
investigated the possibility of the use of the
determination of plasma maspin level for the
diagnosis of cancer.
Methods: Maspin (a mammary serpine inhibitor),
an anti breast cancer protein produced abundantly
in the normal mammary epithelial cells but not in
malignant breast tissue. Maspin was assayed by
enzyme linked immunosorbent assay (ELISA). A
total of 35 female breast cancer patients (between
the ages of 45-65) participated in the study. An
equal number of age matched female volunteers
also participated in the study. None of the cancer
patients at presentation underwent any therapy for
the condition. The staging were T-1=6, T2=8,T3=9,
N0=5, N1-N3= >, stage I+II=30, Stage III=5,M0=0.
Maspin was assayed in the collected blood sample
as soon as practicable.
Results: The plasma maspin level was
4.67±0.04nM in normal volunteers (n=35). In
contrast basal plasma level of maspin was
0.95±0.01nM (n=35, p<0.0001). Furthermore
decrease of plasma maspin level was inversely
related to the increase of malignancy grade of the
condition.
Conclusion: Plasma maspin level could be a useful
marker for the diagnostic test for human breast
cancer.
Abstract No: 1.5
Evaluation of Serum Tumor Markers and Fertility Hormones in Postmenopausal
Women with Ovarian Cancer
L. Vishnu Prasad1 and Dr.R.Arivazagan2
1
Sono Diagnostics, Chennai, 2Department of Biochemistry, Cancer Institute, Chennai
Objective: To observe the levels of fertility
hormones along with tumor markers in ovarian
cancer subjects compared with age matched
controls.
Materials: In this study we analysed serum
samples for CA125, Free beta HCG, AFP, FSH,
98
LH Prolactin and Testosterone assays in 88 Female
subjects, Who were attending the oncology clinic
in Chennai .All the subjects were Post Menopausal
women age 40 yrs or more. Blood samples were
collected from both study group with out any
treatment and 20 healthy age matched subjects.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Method: All the test were analysed. by Testosterone, Free beta HCG, AFP) is more than
Chemiluminescence (CLIA) technique using 0.3814 which is not statistically significant.
Immulite 1000 – siemens analyzer as per
Conclusion: From the above data it was found that
manufacturer protocol.
58 % of ovarian cancer patients have elevated
Result: We have observed that out of 88 ovarian CA125. FSH was in the higher normal range in
cancer subjects 51 had elevated CA125 levels. Out 52% of CA125 elevated subjects than in normal
of 51 subjects who had elevated CA125 levels. subjects and in CA125 level within normal limit
Mean is 996 u/l (P=0.0162) and FSH. Mean is of study group. Therefore the combination of CA
86.9 u/l (p=0.0049). The CA125 level within 125 and FSH may be a better biomarker for
normal limit of Ovarian cancer subjects was not ovarian cancer patient before and on Followup
statistically significant while the mean is 16.3 u/l. treatment to monitor the tumor burden and
The p value for other parameters (LH, Prolactin, treatment response.
Abstract No: 1.6
Serum sialic acid forms as tumors head, neck, thyroid & lung tumors.
Mahendra R. Pakhale , Dr.Murhar and Rajesh Rajrkar
Dept. of Biochemistry, Yavatmal (M.S)
Objective: Serum sialic acid levels are
significantly elevated in thyroid tumors, head &
neck, lung tumors. Such elevation correlate with
tumor progression & metastasis. Generally serum
lipid bound sialic acid levels are elevated in cancer
patients.
Methods As compared to healthy subjects &
patients with chronic non-tumors diseases.
Patients with metastatic disease have higher values
than ones with localized tumors. Serum sialic acid
levels are often elevated in patients with lung
cancer. Patients in clinical remission following
chemotherapy also show elevated mean serum
sialic acid levels. Sialic acid levelsare also
increased in nonmalignant growth of breast tissue
during pregnancy & lactation. Despite the low
specification of serum sialic acids as tumor
markers their levels seem to be related to clinical
course of disease & could be useful in the
monitoring of tumor progression.
Results:Total sialic acid levels were also found to
be increased in serums from lung cancer patients
as compared to the healthy controls. in patients
with metastases these levels are further increased.
As a rile serum lipid bound sialic acid is elevated
in serums from patients with lung cancer. Lipid
bound sialic acid serum changes could be
correlated with the extent of disease.In some of
the studies no statistically significant difference
between patients with chronic non tumor diseases
& cancer patients could be established. However,
lipid bound sialic acid levels are significantly
higher in patients with metastatic disease compared
to ones with loclized timor. Serum lipid bound
sialic acid levels hanged during intensive
chemotherapy almost parallel with the clinical
course, & hence lipid bound sialic acid can be of
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
potential use for following the course of
chemotherapy.
Conclusion: Combined measurements of total
sialic acid & lipidbound sialic acid in serum from
patients with lung cancer could be more
discriminatory than values of either of these
markers. Combination of these markers might be
useful for differentiation between benign &
malignant conditions & also for diagnosis of
metaststic lung cancer. Comparison between total
sialic acid & lipid bound sialic acid values could
also discriminate between different tumor types
or between patients with & without metastases.
Abstract No: 1.7
Matrix Metalloproteinases and Their Inhibitors: Correlation with Invasion and
Metastasis in Oral Squamous Cell Carcinoma
Ragini D. Singh1, N Haridas2, Shilin N. Shukla1, Jayendra B.Patel1, Bhairavi N. Vajaria1 and
Prabhudas S. Patel1
1
Biochemistry Research Division, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad - 380 016,
Gujarat, 2Pramukhswami Medical College, Karamsad, Anand, Gujarat,Email: [email protected]
Objective: Matrix metalloproteinases (MMPs) malignant tissues as compared to adjacent normal
have been implicated in the invasion and tissues. A significant positive correlation was
metastasis of various malignancies.
demonstrated between levels of proMMP-9 and
active MMP-9 with differentiation, stage and
Methods: The study evaluated a comprehensive
infiltration. ProMMP-2 and active MMP-2
profile of MMP-2 and MMP-9 and their main
exhibited significant correlation with
inhibitors, TIMP-2 and TIMP-1, respectively in
differentiation and lymph node involvement. The
50 controls and 75 patients with primary oral SCC.
multivariate analysis of ELISA results revealed a
Blood samples from controls and patients as well
as malignant and adjacent normal tissues from the significant positive correlation between MMP-2,
patients were collected. The study examined pro, TIMP-1 and TIMP-2 levels with lymph node
active and total forms of MMP-2 and MMP-9 involvement, stage and differentiation.
using zymography. ELISA and RT-PCR were
carried out to evaluate protein levels and m-RNA
expression respectively for the MMPs and TIMPs.
Results: Significantly higher plasma pro, active
and total MMP-2, MMP-9 as well as TIMP-1 and
TIMP-2 levels were found in oral cancer patients
as compared to the controls. mRNA expression of
the MMPs and TIMPs was significantly higher in
100
Conclusion: The ROC curve analysis showed that
the levels of MMPs and TIMPs have significant
discriminatory efficacy to discriminate between
controls and patients. The results indicate that
MMP-2, MMP-9, TIMP-1 and TIMP-2 have
significant clinical usefulness for oral cancer
patients. Zymographic analysis is a simple, cost
effective, rapid and sensitive alternative assay.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 1.8
A Study of Oxidative Stress in Cancer Patient before and after Supplementation of
Vitamin C and E
Dr. Pranami Bordoloi , Dr. Bikash Kr. Chaudhury, Dr. Chandan Kr. Nath and Dr. Dipali Das
Department of Biochemistry, Gauhati Medical College and Hospital, Guwahati – 781032 Assam.
Email: drpranamibordoloi @ gmail.com
Objective: Cancer is the second leading cause of
death behind heart disease. Increased lipid
peroxidation is due to the altered ratio between
free radicals and antioxidant status. The study was
carried out to analyze and evaluate the relationship between antioxidant vitamin C & E supplementation and its effect on the lipid peroxidation
in the cancer and normal population.
Methods: We estimated Malondialdehyde, lipid
peroxidation marker colorimetrically by
Thiobarbituric acids Reactive Substances
(TBARS) and uric acid is by Uricase method. Statistical analysis is done by Student‘t’ test. MDA
values in both the study groups decreased significantly after 7 days of vitamin supplementation
(p<0.001)
Results: Uric acid values in both the studied group
increased significantly after Vitamin Supplementation for 7 days (p<0.001).
Conclusion:The study suggested that MDA value
reduced in cancer patients within one week of antioxidant vitamin supplementation but for reduction of uric acid levels longer period of vitamin
supplementation is required in both the population.
Abstract No: 1.9
Role of Serum Enzymes in Oral Cancer.
Dr P.B Desai and Dr. Shikha Sharma
Department of Biochemistry, J.N Medical College, Belgaum, Karnataka,Email:[email protected]
Introduction: Oral cancer is the most common
type of Head and Neck cancer and is a major health
problem in developing countries. The survival
index is small (50%) as compared to the progress
in the diagnosis and treatment of other tumours.
Thus there is a need for the improvement in
detection of early stages as treatment is more
effective and morbidity minimal. A majority of
the initial alterations in these lesions are not readily
recognizable on clinical or histopathological
examination. Therefore a number of biochemical
markers have been studied to evaluate the
malignancy. In view of this, the present study is
undertaken to provide some promising biomarkers
namely Adenosine deaminase (ADA) and 5’Nucleotidase (5’-NT) which are inexpensive,
accurate and identifiable by easy methods of
detection and therefore may be of some diagnostic
and prognostic significance.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: A total of 20 clinically and
histopathologically confirmed male patients of
oral cancer in different stages were included in
the study. There were in the age group of 35-65
years. Normal subjects were taken as controls. 5ml
of blood was drawn and ADA was estimated by
method of Galanti and Giusti and 5’-NT by method
of Campbell.
Results: The levels of ADA and 5’-NT were
significantly elevated in oral cancer patients in
comparison to controls. An increase in these
biomarkers was also seen when interstage
comparison was done.
Conclusion: The rise in ADA and 5’-NT activity
in cancer patients occurs due to enzyme leakage
from the primary cancerous or metastatic tissue.
The rise in activity in relation to the stage further
suggest that increase in tumour mass may be
directly responsible for the increased levels of the
enzyme. Thus these markers are of diagnostic and
prognostic significance in case of Oral Cancer.
Abstract No: 1.10
Biochemical and Hematological Markers in Patients with Chromosome 22q11.2
Deletion and Conotruncal Defects.
Alka Anilkumar,1 M.V.Thampi,1 R.Krishna Kumar,2 K.Mahesh,2 Sheela Nampoothiri,3
Sindu T.K,4 and D. M. Vasudevan.5
1
Dept. of Human Cytogenetics, 2Dept. of Pediatric Cardiology, 3Dept. Pediatric Genetics, 4Dept. of
Biostatistics, 5Ex-Dean, Faculty of Medicine, Amrita Institute of Medical Sciences and Research Centre,
Elamakkara, Cochin – 682026, Tel.0484-4008194, Fax:0484-2802020, Email:
[email protected]
Background: The incidence of 22q11 deletion
syndrome is found to be 1 in 4000 live births. Gene
dosage reduction like heterozygous deletion of
chromosome 22q11.2 region leads to 22q11
deletion syndrome. Phenotypic variability is one
of cardinal feature of this syndrome. Cardiac
mainly conotruncal defects, hypoparathyroidism,
hypocalcaemia and typical dysmorphic features
are some well-described associations. Only limited
data is available regarding abnormal thyroid
functions and hematological manifestations in
22q11DS.
Method: Retrospective study carried out on 168
children (d”2 years) with conotruncal
malformations. 22q11 deletion was analysed by
Fluorescence in situ hybridization technique. Total
Serum Calcium level, Serum Thyroid stimulating
hormone (TSH), Mean Platelet volume and platelet
count were also studied.
Results: 19% of patients were hemizygous for
chromosome 22q11.2 region. A higher mean
platelet volume (MPV) about 10.45fL was found
in deleted patient group as compared to 7.6fL in
the non-deleted patients (p <0.001). A negative
Objective: To identify biochemical and correlation obtained between MPV and platelet
hematological markers of 22q11.2 deletion count. None of the deleted patients had
syndrome.
hypothyroidism. However significant association
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
was found between deletion and calcium level (p microdeletion. Abnormalities of TSH level were
<0.001).
not found to be a feature of 22q11DS. Elevation
of MPV may be due to deletion of the platelet
Conclusion: Mean platelet volume, platelet count
glycoprotein gene GP1BB besides other candidate
and calcium levels can be used as laboratory
genes like TUPLE1, TBX1 and UFDIL located on
markers for clinical identification of 22q11
the chromosome 22q11.2 region.
Abstract No: 1.11
Enhanced 5HT2A Receptors in the Cerebral Cortex of Hypoxia Induced Neonatal
Rats: Effect of Glucose and Oxygen Supplementation
Anju T. R, Pretty Mary Abhraham and C. S. Paulose
Molecular Neurobiology and Cell Biology Unit, Centre for Neuroscience, Department of Biotechnology,
Cochin University of Science and Technology, Cochin- 682 022, Kerala, India. [email protected]
Objective: Hypoxia at birth causes changes in
brain neurotransmitters depending on its severity
and durations. Serotonin (5-hydroxytryptamine;
5-HT) is one of the major neurotransmitters
participating in the development of hypoxiainduced pulmonary hypertension. Ventilatory
long-term facilitation during hypoxia requires 5HT2 receptors. We investigated the 5HT2A receptor
functional regulation in the cerebral cortex of
hypoxia induced neonatal rats and the role of
glucose and oxygen supplementation in regulating
the receptor alterations due to hypoxia.
Methods: Wistar neonatal rats of 4 days old used
for the experiments were grouped into five as
follows: (i) Control (C); (ii) Hypoxia (Hx); (iii)
Hypoxic neonatal rats injected with 10% dextrose
(500mg/ Kg body wt) intra-peritoneally (i.p.)
(Hx+G). (iv) Hypoxic neonatal rats injected with
10% dextrose (500mg/ Kg body wt) i.p. and
treated with 100% oxygen (Hx+G+O); (v)
Hypoxic neonatal rats treated with 100% oxygen
(Hx+O). 5HT2A receptor was assayed according
to the procedure of Uzbekov et al, 1979.
Results: Under hypoxic condition neonatal rats
showed a significant increase in receptor number
(B max) with a decreased affinity (p<0.001).
Resuscitation with glucose (Hx + G) and glucose
along with oxygen (Hx + G + O) showed a
significant reversal to near control. Hypoxic
neonatal rats treated with 100% oxygen (Hx + O)
showed a significant increase in Bmax (p<0.001)
compared to control. Real Time PCR analysis also
showed a significant increase (p<0.001) in the gene
expression of 5HT2A receptors in hypoxic neonates.
The gene expression showed a reversal to near
control in Hx + G and Hx + G + O. Pulmonary
hypertension during hypoxia can be attributed to
the increase in 5HT receptors in the cortex. Glucose
alone and glucose + oxygen supplementation
reversed the altered receptors in the developing
brain of hypoxic neonatal rats.
Conclusion: This has clinical significance in
neonatal care and healthy intellect during later
developmental period.
Acknowledgment: This work is supported by
grants from DST, DBT, ICMR and KSCSTE
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 1.12
Diagnosis of Organic Acidurias in Children - 2 Years Experience in a Tertiary
Care Center
M P Narayanan, Kannan Vaidyanathan and D M Vasudevan
Metabolic Disorders Laboratory, Dept. of Biochemistry, Amrita School of Medicine, Amrita Vishwa
Vidyapeetham, Cochin-682041, Kerala, India. Email: [email protected]
Objectives
1) . To screen 420 patients with signs and
symptoms of organic aciduria / aminoaciduria.
2) To identify and quantify organic acids and
amino acids by HPLC.
Methods: Manual screening tests and thin layer
chromatography were used to detect the presence
of abnormal metabolites in urine. HPLC was done
for organic acid and amino acid analysis using
standard protocols. Clinical details of the patients
were collected from proforma. CT/MRI were used
to evaluate the brain abnormalities.
Results: We studied 420 children upper age limit
12 years with signs and symptoms of organic acid
/ amino acid disorders. Abnormal cerebral CT/
MRI findings were found in 11 patients, and
abnormal EEG findings in 63 patients. 110
samples found positive for organic acids by initial
screening tests. Out of which 41(9.7%) cases of
Organic acidurias were diagnosed by HPLC. 15
cases of Methylmalonic aciduria, 16 cases of
Propionic aciduria, 7 cases of Maple syrup urine
disease, 2 cases of Alkaptonuria and 1 case of
Isovaleric aciduria were found. Common
symptoms of Organic aciduria patients were
seizures (N=17), delayed milestones (N=12), skin
rashes (N=10), abnormal muscle tone (N=6), poor
feeding (N=12), mental retardation (N=12),
encephalopathy (N=1) and hyperammonemia
(N=30). 10 patients were from consanguineous
families. 15 patients expired during the study.
Conclusion: Methylmalonic aciduria, Propionic
aciduria and Maple syrup urine disease account
for 90% of organic acidopathies detected. HPLC
quantification of amino acids and organic acids
helps to identify organic acidurias. Prompt
diagnosis allowed specific treatment in majority
of these patients with rapid improvement.
Abstract No: 1.13
Detection of Inborn Errors of Metabolism in Paediatric Age Group in a Tertiary
Care Centre.
Saritha KamathU1, Licy C.D1, Nalini Bhaskaranand2 and Anjali Rao3
1
Department of Medical Laboratory Technology, MCOAHS, 2 Department of Paediatrics, 3Department
of Biochemistry, KMC, Manipal.
Objective: Inborn errors of metabolism (IEM)
may occur anywhere in the biochemical
machinery of living cells. Although some 150-200
inborn errors of metabolism of clinical interest
are known at present, a few thousand enzymes
and structural proteins have so far been described
104
in human cells; thus it is likely that the types of
inborn errors so far described represent only a
fraction of those actually occurring. A large number
of inborn errors of metabolism in children remain
undetected in India due to lack of awareness,
investigative facilities and economic constraints.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: We examined 21 children presenting protocol. We have come across following cases in
with neurological and metabolic problems at a the course of our study- methyl malonic aciduria,
tertiary level teaching hospital in Karnataka for homocystinuria, and maple syrup urine disorder.
inborn errors of metabolism using a standard
Abstract No: 1.14
Hyperprolinemia in 22q.11 Deletion Syndromes and its Association with
Neurological Deficits
Sweetha Mary Mammen1, Dr. K.N. Subhakumari1 and M. V. Thampi2
1
Department of Biochemistry, 2Department of Human Cytogenetics, Amrita Institute of Medical
Sciences, KERALA
Type 1 hyperprolinemia is biochemically
characterized by a defect of the proline
dehydrogenase enzyme (McKusick 239500). The
enzyme has been mapped to the PRODH gene on
the human chromosome 22 on band q11.2. This
gene falls in the region deleted in the 22q11
Deletion Syndrome, which includes DiGeorge and
Velo-cardio-facial syndromes. Neurological
manifestations have been reported in several
hyperprolinemic subjects. The paucity of previous
research in this subject in India is investigated this
study.
Methods: Plasma proline levels were assayed
(using high pressure liquid chromatography) in 14
children affected with 22q11 deletion syndrome.
The neurological and development statuses of the
hyperprolinemic subjects were studied.
Results: Seven subjects had proline levels above
normal and seven were within the normal limits.
Three subjects had varying degrees of
psychomotor deficits, including delayed
milestones, global developmental delay and
decreased IQ.
Summary: In concordance with previous studies,
this study finds that hyperprolinemia is a common
finding in 22q11 deletion syndrome. Besides, it is
1 To study the frequency of type 1
in agreement with prior studies, stating an
hyperprolinemia in patients diagnosed with
22q11deletion syndrome at Amrita Institute of association between hyperprolinemia and
neurological disorders. A low proline diet is
Medical Sciences, Kerala, India.
suggested since prior research has shown that it
2. To examine the association between plasma
improves growth and development in
proline levels and clinical features (neurological hyperprolinemic individuals.
deficits) of the above patients.
Objectives:
Abstract No: 1.15
Hypoglycaemia
Biswajit Saha
Durgapur Steel Plant Hospital, Durgapur – 713 205, West Bengal (India); e-mail :
[email protected]
Hypoglycaemia is a medical emergency. In day caused by “over administration” of antidiabetic
to day clinical practice, this condition is commonly drugs. Hypoglycaemia is defined when the plasma
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
glucose level is usually less than 45 –50 mg/dl.
However, chemical hypoglycaemia is not
synonymous with clinical hypoglycaemia which
requires demonstration of Whipple’s triad –
symptoms consistent with hypoglycaemia,
documentation of a low plasma glucose
concentration and relief of symptoms after plasma
glucose level has been raised. Interestingly, the
threshold for hypoglycaemia varies widely in an
individual diabetic patient as a result of alteration
of metabolic setpoint from time to time in different
clinical settings. Relative hypoglycaemia occurs
with blood sugar level above 50mg/dl. Conversely,
remarkable lowering of threshold is found in
diabetic patients as a result of recurrent attacks of
hypoglycaemia. Surprisingly, in some otherwise
normal (nondiabetic) individuals, marked lowering
of blood glucose level is not associated with any
symptom(s). The details of causes, clinical
manifestations and management will be discussed.
Abstract No: 1.16
Dyslipidemias
Prof. N. Haridas
Professor and Head, Department of Biochemistry PS Medical College, Karamsad
The Plasma lipoproteins are spherical
macromolecular complexes of lipids and specific
proteins (apoproteins or apolipoproteins). The
lipoprotein particles include chylomicrons, very
low density lipoproteins (VLDL), low density
lipoproteins (LDL) and high density lipoproteins
(HDL).They differ in lipid composition, size,
density and site of origin. Lipoproteins function
both to keep their component lipids soluble as they
transport them in the plasma and to provide an
efficient mechanism to transport their lipid
components to (and from) the tissues. In humans,
the transport system is less perfect than in other
animals and, as a result, humans experience a
gradual deposition of lipid-especially cholesterolin tissues. This is a life threatening occurrence
when the lipid deposition contributes to plaque
formation, causing the narrowing of blood vessels
(atherosclerosis). The talk shall include a
discussion on the metabolism of lipoproteins and
lipids and how their metabolism alters in diseases
like diabetes mellitus, metabolic syndrome,
familial hyperlipo-proteinemias, obesity and
athero-sclerosis. Mention also shall be made about
blood investigations like lipid profile and other risk
factors like lipoprotein ‘a’, homocysteine, creactive protein and dietary fat. Certain preventive
measures like dietary modifications to ward off
atherosclerosis and subsequent heart ailments
would also form a part of the discussion.Certain
interesting observations on lipd profile soon after
acute myocardial infarction shall be discussed.
Abstract No: 1.17
Effect of Swimming on Selected Health Parameters of Beginners
Ragini Srivastava, Royana Singh, Ratna Pandey and Amit Srivastava
Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi.
Email- [email protected]
Background: Exercise has been shown to be a
simple and economical preventive modality that
may be considered as a beneficial adjuvant for
106
many life style diseases(LSD). This study has been
done to investigate the impact of swimming on
biochemical, anthropometric and physiological
Indian Journal of Clinical Biochemistry Supplement, 2009/24
parameters representing health and fitness in a high-density lipoprotein (HDL) were determined.
short period.
Anthropometric parameters related to girth and
width measurements like height, weight, BMI,
Methods: This prospective randomized study
body fat mass and chest circumference were taken.
consisted of 30 cases in the swimmers group that
Physiological parameters related to pulmonary
was matched with 26 controls in non-swimmers
group. Biochemical parameters such as fasting function test were measured at baseline and after
blood glucose (FBG), serum total cholesterol 10 weeks intervals. Results: Study yet to be
(TC), triglycerides, low-density lipoprotein complete and therefore results will be discussed
(LDL), very low-density lipoproteins (VLDL) and at the time of presentation.
Abstract No: 1.18
Evidence-Based Guidelines for the use of Biochemical Markers of Bone Turnover
in the selection and monitoring of Bisphosphonate Treatment in Osteoporosis: A
Consensus Document of the Belgian Bone Club
Dr.Maulik Nayak, Dr. Alok Parekh, Dr.Rita Shah and Dr. D.A. Trivedi
Objective: To review the clinical value of bone
turnover markers (BTM), to initiate and/or
supervise anti-resorptive management for
osteoporosis compared with bone mineral
density(BMD) and to evaluate proper BTM and
changes in BTM levels for significance of
treatment efficiency.
not supported with current records. However, they
can be used to monitor treatment efficiency before
BMD changes can be evaluated. Early changes in
BTM can be used to measure the clinical efficacy
of an anti-resorptive treatment and to reinforce
patient compliance.
Discussion: An optimal long-Term effect is not
Methods: Consensus meeting generating
guidelines for clinical practice after review and
discussion of the randomized controlled trials or
meta-analyses on the management of osteoporosis
in postmenopausal women.
Results: BTM cannot be used as predictive
markers of BMD in an individual patient even if
the correlation between BMD & BTM is
statistically significant. Both are independent
predictors of fracture risk, but BTM can only be
used as additional risk factors in the decision to
treat. The use of BTM select for optimal treatment
evident with determining BTM reflecting
threshold. The objective should be return to the
premenopausal range and / or a decrease at least
equal to the least significant change (30%).
Preanalytical & analytical variability of BTM is
important limitation to their use.
Conclusion: Consensus regarding the use of BTM
resulted in guidelines for clinical practice. BMD
determines the indication to treat osteoporosis &
reveal treatment efficiency. It can motivate patients
to persist their medication.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 1.19
Requirement of Essential Fatty Acids: An Analytical Approach
Dr. Sankar Roy
Asst. Prof., Tripura Medical college & Dr. BRAM Teaching Hospital, Hapania , Agartala- 799014,
Tripura
Each animal or plant species has a specific pattern
of fatty acid composition in their body. Human
body contains more unsaturated FA(60%) than
saturated FA(30%). This ratio (2:1) is essential to
maintain structural and metabolic function of cell
membrane. Body synthesizes Eicosa pentaenoic
acid, Docosa hexaenoic acid and Prostaglandins
from essential fatty acids. But if the dietary PUFAs
are in excess , they compete with or inhibit
phospholipases and acyltransferases. The dietary
PUFAs are incorporated into the structural lipids
about 20 times more than the ve novo synthesized
long chain fatty acids.
Ratio of w-6 / w-3 is also to be maintained about
1:1. But modern diet contain more than 10:1.
Therefore, it is recommended to consume more
w-3 fatty acid containing foods like Soybean oil
(7%), vegetable oil, marine fish to equalize w-6
but not in excess amount.
Abstract No: 1.20
Clinical Approach to Integrated Basic Sciences Teaching
Shruti Mohanty
Department of Biochemistry, Kamineni Institute of Medical Sciences, Narketpally.
Email: [email protected]
Objectives: 1.To compare the performance of
students experiencing integrated teaching with
those exposed to traditional didactic lectures
without integration. 2. To evaluate the
acceptability of integrated teaching and clinical
case discussion to first year medical students.
teaching methodology. Evaluation of the Clinical
case solving valuated the higher order cognitive
skills of the learners.
Results: The pre and post test scores of both the
group experiencing integrated teaching and
traditional didactic lectures were compared. The
Method: Nine faculty members trained earlier mean pre and post test scores in the group that
during in house ME workshops volunteered to underwent intervention were 4.5/15 and 9/15
participate in the project. Three modules were respectively whereas the pre and post test scores
designed and implemented on fifty alphabetically of the group exposed to traditional teaching were
selected students of the 150 enrolled in first year 4.1/15 an 6/15 respectively. Moreover forty two
MBBS course. Pre & Post test scores were of fifty students who experienced the intervention
analyzed to determine the relative impact of the solved the cases correctly but only twenty two
two teaching approaches on student learning. Pre students out of fifty could solve correctly in the
validated questionnaires for students and faculty group that experienced traditional teaching.
were introduced to assess their perceptions on the Majority (88%) of the students experiencing
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
integrated teaching agreed that the integrated
approach helped them correlate across Anatomy ,
Physiology and Biochemistry. 96% of students
and 100% (9) faculty expressed that integrated
teaching helped the students understand and
therefore retain the subject better. Likewise, 96%
students and 100% faculty expressed that this
method of teaching will certainly help the students
perform better in examination.
Conclusion: With minimal intervention of
juxtaposing similar topics and having small
group discussions the students’ performance in
examination improved two fold when compared
to the traditional method.
Abstract No: 1.21
A Study on Organic Aciduria: Detection and Quantification using HPLC
Aswathi K.I, Narayanan MP and Kannan Vaidyanathan
Dept of Biochemistry, Amrita School of Medicine, Kochi, Kerala, INDIA. Email: [email protected]
Objective: Organic aciduria is a group of
disorders characterized as autosomal recessive. It
is primarily due to defect of an enzyme, which
results in block in a particular metabolic pathway.
A pilot study was done to identify and quantify
the different Organic acids using HPLC.
Methods: The study was carried out at Amrita
Institute of Medical science and Research centre,
Kochi. 184 urine samples were taken from Organic
aciduria suspected children between the ages of 0
– 15 years during a time period of one year from
May 2008 – April 2009. Initially samples were
screened for Organic acids by thin layer
chromatography. This was followed by HPLC to
confirm the presence and to identify and quantify
the individual Organic acids.
Results: For the study, 184 urine samples were
screened, 39 showed organic aciduria by screening.
26 were confirmed as positive cases on further
detection using HPLC. There were 34.6% cases
of Propionic aciduria, 26.9 % cases of
Methylmalonic aciduria and 7.6% cases of lactic
aciduria.
Conclusion: This study shows that the incidence
of Organic aciduria is high and HPLC helps in the
easy detection of individual organic acids present
in the urine from which the metabolic disorder can
be confirmed. Thereby, early treatment can be
initiated to avoid morbidity and mortality.
Abstract No: 1.22
ELISA based Evaluation of 17-á Hydroxy Progesterone as a Diagnostic Marker for
Congenital Adrenal Hyperplasia and Assessment of Hyperhomocysteinemia in
Coronary Artery Diseases and Cerebrovascular Accidents
Jayakumar N., Dr. Sujaya P and Dr. Kannan Vaidyanathan
Department of Biochemistry, School of Medicine, Amrita Institute of Medical Sciences, Kerala.
[email protected]
Background: Congenital Adrenal Hyperplasia synthesize cortisol, and in most instances, also the
(CAH) is a family of autosomal recessive inability
to
synthesize
aldosterone.
disorders characterized by the inability to Hyperhomocysteinemia, has recently been
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
associated with increased risk of vascular disease.
The effect of elevated homocysteine is
multifactorial, affecting both the vascular wall
structure and the blood coagulation system.
Objective: To assay 17 – OHP levels in patients
suspected with Congenital Adrenal Hyperplasia
using ELISA & to evaluate its use as a Diagnostic
marker for Congenital Adrenal Hyperplasia.
Assessment of Hyperhomocysteinemia as a risk
factor for Coronary Artery Disease &
Cerebrovascular Accident.
Results: 53/160 subjects showed elevated 17hydroxy progesterone (33%) levels. Based on the
clinical findings, out of 160 patients, 73 patients
were diagnosed as having Congenital Adrenal
Hyperplasia. (45%). 51/170 patients showed
elevated homocysteine (30%) levels. Among the
observed 51 hyperhomocysteinemic subjects, 21
of them were affected by stroke (41%).
Conclusion: This study suggests that
Hyperhomocysteinemia is associated with
Cerebrovascular Accidents and Coronary Artery
Disease and that it is an independent risk factor
Methods: The DEMEDITEC 17- á -OH for the same. Besides, the basal measurement of
Progesterone Enzyme Immunoassay kit was used 17-OHP can be considered as a valuable test for
for the assay of 17-á-OH progesterone in serum the initial diagnosis of CAH, however one has to
of160 patients suspected of CAH. Bio-Rad Micro correlate with the clinical symptoms for the
plate Enzyme Immunoassay Homocysteine Test confirmation.
was used for the estimation of homocysteine in
170 patients.
Abstract No: 1.23
Standardisation of Chromatographic Techniques: HPLC & GC – A Diagnostic Tool
for Inborn Errors of Metabolism
Ms. Amalmol Peter and Dr. Kannan Vaidyanathan
Department of Biochemistry, AIMS, Cochin.
Inborn Errors of Metabolism are hereditary
affections resulting from incompetence in
enzymatic reactions of intermediary metabolism.
At present, several hundred hereditary metabolic
disturbances are known, many of which
correspond to severe life-threatening disorders.
Many IEM have similar clinical presentations,
making the early diagnosis difficult. Procedures
for the qualitative detection and quantitative
determination of diagnostic markers are based on
a variety of methods.Chromatography has played
a pivotal role in the diagnosis of IEM.
Objective: This study aims to standardize HPLC&
GC to the analysis of organic acids & amino acids
for the detection of Inborn Errors of Metabolism.
110
Methods: The study was carried out at Metabolic
Disorders Laboratory, Department of
Biochemistry, AIMS, Cochin, during the period
10.12.2008 to 30.04.2009.For standardizing
HPLC, 17 aminoacids & 6 organic acids were
tested at varying concentrations and the analysis
was performed on Shimadzu HPLC – DAD LC
10.For standardizing GC, 5 organic acids were
tested using varying concentrations & the analysis
was performed on Shimadzu GC- FID 2014.
Results: Validation studies for aminoacids &
organicacids by HPLC showed better sensitivity
and steability at retention times than other
methods. Both the standard amino acid and the
organic acid showed a good linearity for 3 different
Indian Journal of Clinical Biochemistry Supplement, 2009/24
concentrations.Validation studies for organic acids
by GC using BSTFA: TMCS (Bis - trimethylsilyl
trifluoroacetamide: Trimethyl chlorosilane)
derivatizing agent showed faster separation than
other methods.
Conclusion: From the present study, it can be
concluded that, the methods described in this study
permitting both the identification & quantification
of organic acids & amino acids in urine, plasma or
amniotic fluid for the diagnosis of Inborn Errors
of Metabolism with good precision & sensitivity,
minimal manual handling and the advantage of a
more versatile apparatus.
Abstract No: 1.24
Faecal Calprotectin in Inflammatory Bowel Diseases
M.P. Narayanan*, Kannan Vaidyanathan*, O. Gajendra#, S. Shine#..and V. Balakrishnan#
*Dept. of Biochemistry, Amrita School of Medicine, Kochi-682041, Kerala India, #Dept. of
Gastroenterology, Amrita Institute of Medical Sciences and Research Centre, Kochi-682041,
Kerala, India. [email protected]
Background: Inflammatory bowel diseases (IBD)
are chronic intestinal disorders of unknown
etiology and with a typically relapsing course.
Faecal calprotectin, an important granulocyte
cytosolic protein, is closely correlated with faecal
excretion of 111 indium labelled leucocytes,
deemed to be the gold standard for measuring
intestinal inflammation. Assessment of faecal
calprotectin levels has been proposed as a noninvasive test for the direct evaluation of intestinal
inflammation in patients with IBD.
Objective: To compare faecal Calprotectin with
the standard disease activity indices (UCAI and
CDAI) of inflammatory bowel diseases
(Ulcerative colitis and Crohn’s disease).
Methods: Patients diagnosed to have IBD based
on clinical, endoscopic and histological
examination were included. Ulcerative colitis
activity index (UCAI) and Crohn’s diseases
activity index (CDAI) were calculated. Faecal
calprotectin was estimated by a commercially
available quantitative ELISA test.
Results: Forty-three patients were included in the
study, 20 patients with Ulcerative colitis (UC) and
23 with Crohn’s disease (CD). Patients with active
CD (CDAI > 150) were 18/23 (78%) and with
active UC (UCAI > 2) were 17. Mean hemoglobin
was not different in both the groups. Mean ESR
was raised in both groups (37 in UC, 31 in CD; P
= 0.361). Mean CRP was raised in both groups
(UC 49± 60; CD 19±19; P= 0.302). Mean UCAI
was 7 (SD± 3) and mean CDAI was 212 (SD ±
89). Mean faecal calprotectin was 890 (SD±503)
in UC patients and 641 (SD±739) in CD patients
(P = 0.028) Fecal calprotectin was higher in active
cases compared to those in remission but the
difference did not achieve statistical significance.
Correlation of faecal calprotectin with CDAI was
strong (P = 0.0008) whereas correlation of faecal
calprotectin with UCAI was weak (P = 0.274).
Conclusion: Faecal calprotectin correlated
strongly with CDAI but weakly with UCAI. The
difference in patients in remission vs active disease
(as categorized by UCAI and CDAI) was not
statistically significant.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 1.25
A Study on Cytotoxicity and Inhibition of Cyclooxygenase-2 by Curcumin and Diallyl
Sulfide in Head And Neck Cancer Cell Line
Hariharasudan. R
Final year MBBS, Amrita Institute of Medical Sciences, Kochi , Kerala. Email: [email protected]
Objective: To study the effect of curcumin and
diallyl sulfide (DATS) on cytotoxicity and
inhibition of Cyclooxygenase (COX-2) in head
and neck cancer cell lines
Results: The study showed that the IC50 values
for both DATS and curcumin was 5ì M. With
regard to the regulation of COX-1 and COX-2
expression, curcumin and DATS inhibited COX-2.
Methods: MDA 686LN a HNSCC cancer cell
line, maintained in MEM was teated with DATS
and curcumin individually for 24,48 and 72 hours
with a zero hour control in triplicates. The cells
were harvested by trypsin treatment and cell
viability was determined by trypan blue dye
exclusion assay. Total RNA was isolated using
TRIZOL solution and its integrity was checked.
The cDNA was synthesized using both oligo-dT
and random hexamer primers. The level of COX1 and COX-2 expression was analyzed by PCR
in comparison with â-actin using specific primers.
Conclusion: Currently, curcumin has been
introduced into clinical trials in the
chemoprevention of HNSCC and the only
difficulty is its bioavailability. The cytotoxicity
study, using the HNSCC cell line namely MDA
686LN indicated that curcumin and DATS have
greater effect on cell viability. It is proposed that,
the synergistic effect of the combination of
curcumin and DATS should be greater than the
individual clinical compounds. Further studies in
this aspect are currently taken up.
Acknowledgment: : This work was done as a part
of ICMR – STS project.
Abstract No: 1.26
A Study for Investigating the Association between Semen Biochemical Parameters
and Routine Clinical Semen Parameters in Infertile Men
*
Suresh S. and T. Vijayakumar
Department of Biochemistry and Physiology , Educare Institute of Dental Sciences,
Malappuram-675 506, Kerala ,India.
Objective: The biochemistry of semen has been
studied extensively,but the biochemical analysis
of semen has little part to play in the routine
investigation of an infertile man. 1-4 In this context
a study was undertaken with the objectives of
investigating whether there exists an association
between semen biochemical parameters and
clinical semen parameters, so that the latter could
112
be used as an adjunct to the conventional semen
analysis for evolving better seminogram
protocols in the evaluation of male infertility.
Methods: For the present study , semen samples
of 120 infertile men visiting an Infertility Clinic
were collected and the same was used for the
investigations. The study followed the ICMR and
Indian Journal of Clinical Biochemistry Supplement, 2009/24
WHO Ethical Guidelines
for Clinical
Research.The 120 infertile men were divided in
to 3 groups: Normospermic, Asthenospermic and
Oligospermic subjects, based on the sperm count
and sperm motility. There were 32 normospermic,
51 asthenospermic and 37 oligospermic subjects.
The grouping was based on the WHO guidelines
for semen analysis. The results of clinical
parameters such as sperm motility, viable count
and pH were collected from the clinical proforma.
The semen biochemical parameters investigated
in the present study were prolactin, acid
phosphatase, sorbitol dehydrogenase, glucose,
fructose and pyruvate.
Conclusion: Thus, this study reveals that there
exists a strong relationship between the
biochemical parameters studied and the routine
semen clinical parameters of asthenospermic male
subjects with clinical infertility . Although the
present study could not find such a relationship in
oligospermic subjects with clinical infertility,
additional semen biochemical components such as
citrate, choline and spermine as well as the semen
anti-oxidant system should also be analyzed before
rejecting the hypothesis that a similar association
does not exist in oligospermic males with clinical
infertility.
1. Insler.V, Lunenfeld.B.: Infertility: the dimension
of the problem, in Insler.V, Lunenfeld.B (eds)
Results: The results were analyzed statistically
Infertility male and female(2) Peter Richardson
using Mann-Whitney U statistics in the Sigma
1993, Pg.3-5.
Stat 3.5 Version Software. A statistically
significant decrease in all semen biochemical
parameters such as prolactin, acid phosphatase, 2. Attramadal. A, Tveter. K.J, Weddington. S.C. et
al.: Androgen binding and metabolism in human
glucose,fructose, pyruvate and sorbitol
prostate. Vitam Horm 1975, (33) pg.247.
dehydrogenase were observed in asthenospermic
subjects as compared to normospermic subjects ( 3. Pulkkinen. P, Sineroiste. R, Janne. J.:
p <0.001 ) A statistically significant decrease in
Mechanisms of action of oxidized polyamines
prolactin & acid phosphatase and increase in
on the metabolism of human spermatozo J
glucose were observed in oligospermic subjects
Reprod Fertil1978, (51) pg.399.
as compared to normospermic subjects ( p
<0.001).A statistically significant increase in 4. Sheth. A.R, Mugtawala. P.P, Shah. G.V, Rao. SS.:
prolactin and decrease in glucose, fructose and
Occurance of prolatctin in human semen. Fertile
pyruvate were observed in oligospermic subjects
steril 1975, (26) Pg. 905.
as compared to asthenospermic subjects ( p <0.001).
Abstract No: 1.27
Isolation and Validation of the Biomarker MMP1 from Salivary Transcriptome
for Early Detection of Oral Cancer
Kannappan Alagappan, Amritha Suresh and M A Kuriakose
Amrita Institute of Medical Sciences, Kochi.
Background: Oral cancer incidence is on the rise
worldwide with a marginal improvement in
survival rates over the past few decades which is
due to their late presentation at the time of
diagnosis. Early detection would be the most
effective means to reduce death from this disease
and in this regard expression profiling of
biomarkers in saliva appears to holds promise.
Methods: Saliva was collected (1ml) in RNA later
from patients and normal controls and RNA
isolated using QIAamp viral RNA mini kit. DNA
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
contamination was checked by PCR and if
contaminated, DNase treatment was done.
Conversion of the RNA into cDNA was done and
the integrity of cDNA was confirmed by RT-PCR
using GAPDH primers. The expression of MMP1
in saliva was analyzed using specific primers by
semi-quantitative RT-PCR.
patients, one of them progressed to oral cancer on
follow up.
Conclusion: The main aim of a cancer-screening
program is to detect the tumor at an early stage in
order to achieve a better prognosis. The medium
used, if non-invasive and inexpensive like saliva;
the compliance and frequency of the screening
Results: Saliva was collected from 15 patients process can be increased. MMP1 over expression
divided into three groups with 5 subjects in each; in saliva found in this study is suggested to
normal controls, patients with pre-malignant delineate the lesions with a high risk of
lesions and oral cancer. Out of these 15 samples malignancy.
10 showed MMP1 amplification; 4 normals, 2 preAcknowledgment: This wark was done as part
malignant and 4 oral cancers. Patients showed
of ICMR-STS Fellowship
MMP1over expression as compared to the basal
expression in normal controls. Of the 2 PML
Abstract No: 2.1
Serum Copper and Magnesium Level in Type –2 Diabetes Mellitus
B.K.Agrawal1, Seema Tamrakar1 and V.K.Sharma2
1
Dept. of Medical Biochemistry, 2Dept. of Medicine. Gandhi Medical College ,
Bhopal,E-mail:[email protected]
Objective: Diabetes Mellitus is a chronic
metabolic disorder, copper level is increased and
magnesium decreased in Diabetes. Methods: The
present study includes 100 patients of Diabetes
Mellitus compared to 50 healthy persons. Patients
were selected randomly without any bias for age
sex.
1.Serum copper estimated by colorimetric method.
2.Serum magnesium estimated by calmagite
method.
Results: The mean values of copper was found
to be 110.04±13.28µg/dl and magnesium was
1.84±0.45MEq/L in healthy subjects type-II DM
114
The mean value of Copper was found to be
220.04±28.46µg/dl and magnesium was 0.6±0.49
MEq/L in controlled Diabetic patients. The mean
value of copper was found to be 225.87±23.45 /dl
and magnesium was 0.77±0.69MEq/L in
uncontrolled Diabetes. Serum copper level was
significantly increased compared to control group
(p<0.001), whereas serum magnesium level was
significantly decreased (p<0.05) compared to
control group.
Conclusion: It can be concluded that diabetes is
also associated with hypercupremia and
hypomagnesemia.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.2
Biochemical Profile of Cord Blood in Normal Pregnancy and Pregnancy Induced
Hypertension
Miss D.Prathima , Dr. U.B.Vijaya lakshmi and Prof. Dr. K. Ambika Devi
Dept. of Biochemistry, ASRAM Medical college , Eluru, A.P; Email : [email protected]
Background: Pregnancy induced hypertension
(PIH) is a significany health problem and is the
leading cause of maternal and perinatal mortality
and morbidity. Low birth weight and prematurity
is common in such cases.
Objective: This study was designed to compare
certain biochemical parameters in cord blood of
children born to mothers with PIH and to mothers
with normal pregnancy.
Methods: For this purpose 10ml of cord blood
during delivery was collected from mothers
attending obstetrics department at ASRAM
medical college, Eluru.30 samples were collected
from mothers with uncomplicated pregnancy and
50 samples from the mothers with PIH (maternal
age matched). The 50 samples include group A20 mothers with pre-eclampsia and group B-30
mothers with gestational hypertension The
biochemical parameters measured were glucose,
urea, total proteins, total cholesterol, calcium &
magnesium.
Results:It was observed that all the parameters
except for total cholesterol and calcium were
significantly lower (p<0.00001) in the cord blood
of babies born to mothers with PIH.The total
cholesterol and calcium were significantly higher
in the same cases (p<0.001). On comparison of
parameters of cord blood in babies weighing >
2.5kg in cases vs controls, there was significant
decrease in all the parameters in the former.
Conclusion: So the neonates born to mothers with
PIH must be screened carefully to prevent mortality
and morbidity due to low levels of the important
biochemical parameters like glucose and
magnesium. Neonates weighing >2.5kg are also
at similar risk.
Abstract No.2.3
Relationship between Micronutrient Intake of Mothers and Metabolic Outcomes
in Offspring (6 and 12 yrs): Pune Maternal Nutrition Study
S.S.Naik, D.S.Bhat, C. Joglekar and C.S.Yajnik
K.E.M.Hospital Res. Centre, Pune 411000
Objective: Role of micronutrients during the maternal food intake, circulating nutrients and
pregnancy on the development of adiposity in the physical activity twice during pregnancy.
children at 6 and 12 yrs.
Anthropometric measurements on 690 children
born to these mothers were carried out at birth and
Methods: PMNS is a prospective study of
then every six months till 6 yrs and then yearly till
maternal nutrition and fetal growth. We recorded
12 yrs. At 6 and 12 yrs fasting plasma insulin, leptin
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
and lipids were measured. Ethical approval and
consent was obtained.
Results: There was no gender difference in weight
or BMI at 6 and 12 yrs. Girls had higher leptin,
and insulin concentrations at 6 yrs (3.1 vs 2.4 and
3.3 vs 3.03 mU/L respectively) and at 12 yrs (3.9
Vs 2.4 and 5.7 vs 4.7 mU/L respectively). BMI,
insulin and leptin concentrations were directly
associated with adiposity at 6 and 12 yrs (p<0.001
for all). Those who were born thin and grew
rapidly from 3 yrs had higher plasma leptin and
insulin concentrations (p=0.001). Higher maternal
weight gain during pregnancy predicted higher
leptin concentration (p=0.04). At 12 yrs, leptin
concentration was directly associated with weight
and inversely with height even after adjusting for
maternal micronutrients, adiposity at birth and
adiposity at 12 yrs (p=0.017 and -0.038 resply).
Higher maternal BMI and erythrocyte folate
concentration predicted higher adiposity and leptin
concentration at 12 yrs (p=0.04 for both).
Conclusion: Maternal micronutrient intake and
high erythrocyte folate concentration in pregnancy
predict higher adiposity, insulin resistance, and
leptin concentration in the offspring. The effect is
stronger at 12 years, suggesting intrauterine
nutritional programming of adiposity
Abstract No: 2.4
Lack of Awareness Resulting in Lead Poisoning in Unorganized Sector of
Battery Workers
Dr. Vishal Babu G N, Mr. Raviraja A and Dr. T Venkatesh
Department of Biochemistry, St. John’s Medical College, Bangalore, India
Objective: A comparative study of renal functions
and blood pressure of organized and unorganized
sector of battery workers was conducted to study
the effect of lead exposure and lack of awareness
between the organized and unorganized sector.
Methods: Ninety subjects were selected for the
study of which: Group A had 30 Controls; Group
B had 30 organized battery workers and Group C
had 30 unorganized battery workers. They were
evaluated for their Blood lead level, Zinc
Protoporphyrin and renal functions along with
measurement of blood pressure.
Results: This study shows that there is statistical
significance between Group B and Group C in
116
Blood Lead level (p<0.001), Zinc Protoporphyrin
(p<0.001), Urea (p<0.001) and Uric Acid
(p<0.001)
Conclusions: There was significant difference in
blood lead level, Zinc protoporphyrin and renal
parameters between the two sector though there
was no significant difference between the two in
terms of blood pressure. This difference was
mainly due to the absence of precautionary
principles, proper disposal methods and proper
education to workers in the unorganized sector.
This study signifies the importance of all these
principles.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.5
Estimation of Zn, Mg in Several Protein Energy Malnutrition in Children Age Group
6 Month to 5 Year
Farha Ali1, B. K. Agrawal1 and Manjusa Goel2
Department of Biochemistry, 2Department of Paediatrics, Gandhi Medical College, Bhopal,
Email: [email protected]
Results: The mean value of serum Zinc (in age
group 6month to 2yr and 2 yr to 5yr) were found
to be significantly (P<0.001) decreased as
compared to control) were found to be
significantly.(P<0.001) decreased as compared to
Methods: 50 PEM children were studied control. Results obtained from analysis of Mg and
compared to 20 healthy controls divided on the Zinc level were significantly low.
basis of age group 6month to 5yr. Zinc was Conclusion: Thus it can be concluded that, there
estimated calmagite method. Mg was estimated is sever deficiency of Zinc and Mg in PEM children
by colorimetric method.
due to their abnormal metabolism.
Objective: Malnutrition is the cellular imbalance
between the supply of nutrition and energy and
the body demand for them to insure growth
maintenance an specific functions.
Abstract No: 2.6
Zn and Fe Levels in Hypothyroid Subjects: A Hospital Based Case Control Study
Gaurav B. Shetty1, Suchetha Kumari. N 2 and Smitha.P 3,
1
IIIrd M.B.B.S K.S Hegde Medical Academy ,Deralakatte , Mangalore –575018, 2Professor, Dept.of
Biochemistry, K.S Hegde Medical Academy, Deralakatte, Mangalore –575018, 3M.Sc Biotechnology
SDM College Ujire. Email: [email protected]
Background: Excess or decreased secretion of
thyroid hormone leads to hyperthyroidism and
hypothyroidism respectively. Iron is a very critical
mineral for individuals with thyroid disease. Zinc
is one of the most abundant trace elements in the
body. Zinc has close interrelationship with the
endocrine system, it is essential for normal growth,
reproductive function, thyroid function and
glucose metabolism.
Methods: This study was carried out at K.S.Hedge
Medical College Hospital. Individuals were
diagnosed as hypothyroid and normal by ELISA
method .A total of 40 subjects were included in
the studies among them 20 subjects with
hypothyroidism and 20 subjects with normal
thyroid function. Iron was estimated by
Bathophenanthroline method and Zinc by Atomic
absorption spectrophotometer.
Results: Iron and Zinc levels were significantly
decreased in hypothyroidism subjects when
compared to normal subjects.
Conclusion: Our study shows decreased levels of
iron and zinc in hypothyroidism, this may be due
to deficiency in thyroperoxidase activity and
copper level which could interfere with thyroid
hormone synthesis. Hence Iron and zinc
supplements may improve thyroid metabolism in
individuals with hypothyroidism.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.7
Extracellular Mg2+ Decreases Loading of the Ca2+-Sensitive Fluorescent Probe
Chlortetracycline, into Calcium Stores in Lymphocytes and Neutrophils
Nivedita L. Rao1 and Jose Jacob2
1
Department of Biochemistry, Yenepoya Medical College, Yenepoya University, Mangalore-575 018,
Karnataka, 2Department of Biochemistry, Amala Institute of Medical Sciences, Thrissur-680 555,
Kerala; E-mail: [email protected]
Objective: Extracellular Mg2+ is known to inhibit
agonist-stimulated calcium mobilization from
intracellular calcium stores and exocytosis in
several cell types, possibly by decreasing the free
Ca2+ content of the stores.
Methods: We used Chlortetracycline (CTC), a
Ca2+-sensitive fluorescent probe for cellular
calcium stores, to study the effect of extracellular
magnesium on the quantity of CTC loaded into
cells which in turn, depends on the free Ca2+
content of the stores. CTC was loaded into freshly
isolated, viable, mouse spleen lymphocytes and
human blood neutrophils. Estimation of loaded
CTC was done by digitonin-permeabilization of
CTC-loaded cells, to release the loaded CTC and
comparing the Ca 2+ -induced fluorescence
enhancement of CTC with a standard plot. In the
presence of 1 mM extracellular Ca2+, significant
CTC-loading occurred.
Results: Absence of extracellular Ca2+ (and Mg2+)
during CTC-loading caused a decrease in the
quantity of CTC loaded into cells. Presence of 1
mM extracellular Mg 2+ (in the absence of
extracellular Ca2+) caused a further decrease in
CTC-loading. Extracellular Ca2+ replenishes Ca2+
at the stores. Therefore, in the absence of
extracellular Ca2+ (and Mg2+) the quantity of free
Ca2+ at the stores, decreased and consequently,
CTC-loading into those cells decreased. Further
decrease in CTC-loading in the presence of
extracellular Mg2+ (and absence of extracellular
Ca2+) indicates decreased relative free Ca2+ content
at cellular calcium stores.
Conclusion: These results have general
importance in relation to the modulatory role of
Mg2+ on intracellular Ca2+ signaling processes and
the high Mg2+-induced suppression of several
biological functions of cells
Abstract No: 2.8
Expression of Metallothionein (MT) in Colonic Precancerous and Cancerous
Tissue in Animal Model
Pamela Christudoss, and R. Selvakumar
Dept. of Clinical Biochemistry, Christian Medical College –Vellore. Email id: [email protected]
Objectives: 1) To study the MT protein content,
protein expression and mRNA expression in
association with alterations in tissue zinc levels
in DMH (dimethyl hydrazine) induced colonic
precancerous and cancerous tissue in animal
model. 2) To study the effect of Aspirin, vitamin
118
C or zinc supplementation on the metalothionein
mRNA expression, protein expression and content
in colon carcinoma in rat.
Methods: Rats were assigned to 2 groups: control
and test group which received saline and
Indian Journal of Clinical Biochemistry Supplement, 2009/24
dimethylhydrazine respectively for 4 months and
sacrificed at six months. The colon of the rats of
both groups were harvested and fixed in 10%
buffered formaldehyde and processed for
histology study and for immunohistochemistry of
metallothionein expression as per standard
methods. A part of the colon was used for MT
mRNA expression by mRNA Isolation followed
by cDNA conversion and quantitative real time
PCR. Tissue zinc was estimated by Atomic
Absorbtion Spectrophotometry.
mean MT mRNA expression was actually
increased to a level much higher i.e. up to 1.9 fold
and up to 2.4 fold respectively than the saline
treated control rats. When the DMH treated rats
were co-treated with zinc, a mean increase in MT
mRNA expression up to 2.7 fold and 3.25 fold was
observed in the precancerous group and cancerous
group resp. as compared to the saline treated
control rats. When the DMH treated rats were cotreated with aspirin, vitamin C or zinc, the MT
showed a mean immunopositive staining of 58%,
60% and 75% resp; but this did not reach the
Results: Colonic tissue zinc in DMH treated rats
normal MT immunopositivity levels.
decreased by 60-70% as compared to saline treated
controls. The mRNA expression in the DMH Conclusions: This study shows that zinc decrease
induced precancerous and carcinoma model was due to the onset of carcinogenesis co-related with
significantly decreased by 1.33 fold (mean 25% the reduction of MT content, protein expression
decrease) and 10 fold (mean 90 % decrease) and mRNA expression in colon tissues as
respectively as compared to controls treated with compared to normal tissue. This observation
saline. Rats administered only saline showed 95% emphasizes the clinical relevance of this
immunopositivity of the MT protein expression. multifunctional metalloprotein in colorectal
However the administration of DMH resulted in carcinogenesis. We suggest that increased MT
only a mean 20% MT immunopositive staining in mRNA expression and immunopositive staining
the colonic tissue. The DMH treated rats when may be related to the protection against colon
co–treated with aspirin or vitamin C in the carcinogenesis provided by administration of
precancerous and cancerous group, the colonic aspirin, vitamin C or zinc.
Abstract No: 2.9
A Study of Serum Ferritin Levels among Male Blood Donors
Ramesh Kumar1 and Dr.Shanmugam2
Technical Supervisor, 2Director – Blood Bank Services, Life Line Blood Bank & Research Centre,
Tirunelveli, Tamil Nadu
1
Objective: Iron deficiency is the commonest
cause of anemia worldwide and healthy blood
donors are estimated to lose about 175 to 225 mg
of iron with each donation. The objective of this
study was to determine the serum ferritin levels
among first time and regular male blood donors,
and also to correlate the serum ferritin levels with
the number of donations and hemoglobin levels.
Methods: Hemoglobin levels and serum ferritin
were measured in four groups of donors divided
into I group I (single time donor/year), Group II
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
(twice/year), Group III (thrice/ year) and Group
IV (4 times/ year).
Results: The mean haemoglobin in the first time
donors, II group, III group & IV group were
13.99±1.12, 13.78±1.08, 14.01±1.44 and
13.76±1.14 respectively. The changes in
haemoglobin were not statically significant. The
serum ferritin levels were found to be significantly
lower among the regular donors ie Group IV
(52.0±19.78 ng/ml) compared to first time donors
(129.7±36.66), Group II (112.62±34.89) and
Group III (77.12±26.12). The serum ferritin levels
gradually decrease according to the number of
donations and there was a significant correlation
between frequency of donations and the serum
ferritin level.
Conclusion: This date suggest that the blood
banks must check serum ferritin for all the regular
donors apart form haemoglobin and to advice
donors about iron supplementation accordingly.
This is the responsibility of blood bank towards
these very important persons who are donating life
to others by donating blood.
Abstract No: 2.10
Study of Serum Magnesium Levels in Diabetic Nephropahty
M. Ravi kanth1, Dr. A.K. Bansal2 and Mrs. Lincy Jacob3
1
Demonstrator, 2 Professor, 3 Asst. Prof., Dept. of Biochemistry, Govt. Medical College, Jagdalpur,
Bastar – 494001, Chhattisgarh. Email: [email protected]
Objective: Diabetes mellitus has become a global
problem with approximately 221 million people
world wide, and the metabolic disregulations
associated with it causes secondary
pathophysiological changes in multiple organ
system. Kidney is one of the mostly affected organ
which leads to nephropathy. Diabetic nephropathy
has become the leading cause of End Stage Renal
Disease (ESRD), in developing and developed
countries. Cellular magnesium is a critical cofactor in the activity of various enzymes involved
in glucose oxidation like glucokinase,
phosphofructokinase, enolase and also plays a role
in release of insulin. Magnesium deficiency has
been proposed as a novel factor indicated in the
pathogenesis of diabetic complications.
Significant alterations were observed in the serum
magnesium levels of diabetic nephropathy
patients.
Methods: The present study was carried out in
the Dept. of General medicine in NRI Hospital,
120
Chinakakani, Gnt, D.t, A.P. from Jan – May 2008.
The study comprised of 80 subjects, out of which
40 were cases, specifically patients of diabetic
nephropathy with high serum glucose, HbA1c and
urinary microalbumin and 40 were age matched
controls. The statistical data was evaluated using
the Z-test. Drastically increased levels of HbA1c
and urinary microalbumin levels are observed in
cases compared to controls.
Results: The mean ± S.D, serum magnesium levels
(mEq/L) in diabetic nephropathy cases were 1.92
± 0.28 compared with controls 2.142 ± 0.16. The
difference is statistically decreased (P<0.005)
serum magnesium levels in cases and the Z value
is 5.5.
Conclusion: Thus the study concluded the
assessment of decreased magnesium levels
indicates the progression of diabetic nephropathy.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.11
Effect of Aluminum on Cardiac Rhythm of Male Albino Rats: An Electrocardiogram
Study
Sadhana Verma1, 2, Pradeep Kumar1, M. Y. Khan2, Sandeep Tripathi2 and A. A. Mahdi2
Departments of 1Physiology and 3Biochemistry, CSM Medical University, 2Department of
Biotechnology, BBA University, Lucknow, India
Objective: To date, information on the interaction
of aluminum (Al) with cardiovascular functioning
was limited and unclear. Al+3 is a non-essential
element and known to be an extensively used in
modern daily life. The aim of the present study
was to evaluate the long term Al exposure on
Electrocardiogram (ECG) and its correlation with
oxidative markers and pathophysiology of cardiac
muscle.
Results: The result of ‘in vivo’ ECG was found to
be significant (p>0.05) changes in term of heart
rate as compared with the age matched control rats.
Increased lipid peroxide levels were markedly
increased along with decreased antioxidant profiles
i e., SOD, CAT and GSH in Al treated rats when
compared with the controls. The electron
microscopic study exhibited altered and dilated
muscle fiber in Al treated rats. On the basis of the
present study, Al has been demonstrated as a proMethods: We have orally administered 100 mg oxidant and its directly correlated with the altered
AlCl3 (by gavage) to male albino rats (n=6) for 90 biochemical and ultra-structural profiles of the
days. The same number of age and sex matched heart.
rats were concurrently administered equal volume
of physiological saline. After 90 days rats were Conclusion: It may be concluded that the Al
performed to ECG for the evaluation of influence on the rhythm of the heart activity
cardiovascular impairment. Thereafter, rats were associated with the altered antioxidant balance.
sacrificed by cervical dislocation and heart was
removed for the carrying out of lipid and their
peroxidative product.
Abstract No: 2.12
Serum Calcium, Phosphorus and Alkaline Phosphatase Levels in Preterm Babies
Sarika Singh Chauhan1, B. K. Agrawal1 and Rashmi Dwivedi2
1
Department of Medical Biochemistry, 2Department of Paediatrics, Gandhi Medical College, Bhopal.
Objective: Preterm is defined as a baby with a
gestation of less than 37 completed weeks.
Preterms have low serum calcium and phosphorus
levels with increased serum alkaline phosphatase
activity. In this study serum calcium, phosphorus
and ALP activity were measured in preterm
babies.
Methods: The present study comprised of 75
preterm babies. Of which 25 were of 28-30 weeks,
25 were of 30-32 weeks & remaining 25 were of
34-36 weeks (Controls) of gestational age. In these
patients following investigations were done to
assay serum calcium, phosphorus levels and serum
alkaline phosphatase activity.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
1. Serum calcium by OCPC method.
2. Serum phosphorus by Modified Metol method.
3. Serum alkaline phosphatase by Kinetic p-NPP
method.
to be insignificantly increased at 28-30 weeks as
compared to 30-32 weeks of gestational age in
preterm babies. The correlation between serum
calcium & phosphorus were found to be positive
at all gestational ages, whereas Serum ALP is
inversely correlated with serum calcium &
phosphorus at all gestational ages.
Results: Serum calcium & phosphorus levels
were found to be significantly decreased and
Serum ALP activity was found to be significantly
increased (p<0.001) at 28-30 weeks as compared Conclusion: It can be concluded that high serum
to 34-36 weeks (Controls), but serum calcium & ALP activity & low serum calcium & phosphorus
phosphorus levels were found to be insignificantly levels are associated with preterm babies.
decreased whereas serum ALP activity were found
Abstract No: 2.13
Hypomagneseamia in Diabetes Mellitus
Shymala Manga, Dr.B.Prabhakar Rao and Dr.Sunanda
Department of Biochemistry and General Medicine, Prathima Institute of Medical Sciences, Nagunoor,
Karimnagar, Andhra Pradesh, INDIA. E-mail Id: [email protected]
In the present study 20 normals as group -1 and
80 cases of diabetic patients choosen as group11. In both groups serum glucose levels and serum magnesium levels were analyzed by colorimetric method. Mean plasma Magnesium was sig-
nificantly lower in diabetic patients (0.79 + 0.11)
than control subject (1.81 + 0.56). Plasma Magnesium Correlated well both. In conculsion
hypomagneseamia may predispose to Ischemic
heart diseases.
Abstract No: 2.14
Study of Biochemical Markers in Iron Deficiency Anemia
Smita B. Pawar
Lecturer,Department of Biochemistry, M.V.P.’s Medical College Hospital & Research Centre,
Nashik, Maharashtra.
Anemia is the single most common disorder
affecting mankind seen in all parts of the world,
developed as well as developing countries. In India
nearly 70% people are estimated to be iron
deficient. It is misleading to think of anemia as a
single disease with a single cause. The studies of
experimental and human evidences support clear
122
roles for increased oxidative stress due to
susceptibility of lipids of red cell membrane to
peroxidation. A low serum iron alone does not
diagnose iron deficiency, a combination of serum
iron, Total Iron Binding Capacity (TIBC), along
with hemoglobin (Hb) and the trace element zinc
(Zn) are conjunctively essential to diagnose. The
Indian Journal of Clinical Biochemistry Supplement, 2009/24
normal adult erythrocytes can resist oxidative
stress by several antioxidant defense systems.
Whereas, the imbalance between oxidative stress
and antioxidant system is present in iron deficient
patients. In light of the several epidemiological,
clinical and laboratory investigations supporting
the role of oxidative stress in anemia, we aimed
to study the alterations in the levels of oxidants
and antioxidants in-patients of iron deficiency
anemia. In abridgement, present study reveals
alterations in the levels of iron, Hb and TIBC, along
with the augmented free radicals and impaired
antioxidant potential.
Abstract No: 2.15
Estimation of Toxic Lead (Pb) Contamination of Tapioca (Manihot esculenta) in
Kerala State
Subin Joy, Shaikh Mohammed and V V Pillay
Poison Control Centre, Dept of Analytical Toxicology, Amrita Institute of Medical Sciences, Cochin,
Kerala 68206, Email [email protected]
Objective: There have been reports of edible
vegetables containing trace amounts of heavy
metals above the normal permissible levels from
various parts of India, including some parts of
Kerala. Such contamination can have far-reaching
consequences on the human population, making
them potential victims of chronic heavy metal
poisoning. Prolonged human consumption of
unsafe concentration of heavy metals could lead
to disruption of numerous biological and
biochemical processes in the human body. Toxic
concentration of heavy metals in the body can
either act as carcinogens, or cause developmental
abnormalities in children.
particular reference to lead (Pb) in tapioca or
cassava (Manihot esculenta) by lead dithizone
colour test (qualitative), and UV/VIS
spectrophotometer (quantitative). Relatively high
concentration of lead in tapioca cultivated near the
industrial belt of Cochin was observed, which
could be due to the prevalent practice of irrigation
using waste water, containing effluents from
industries.
Result: Lead contamination can occur from lead
pipes and lead-based solder pipe joints through
water. Apart from the industrial area, the lead
concentration of tapioca cultivated elsewhere was
Method: This project was done to estimate the
below the permissible limit of 0.3µg.
content of heavy metal contamination with
Abstract No: 2.16
The Effect of Vitamin E Supplementation on Soluble P-Selectin Levels in PreEclampsia
Sujata Wangkheimayum1, Sunil Kumar1 and Vanita Suri2
1
Department of Biochemistry; 2 Department of Obstetrics and Gynaecology, Postgraduate Institute of
Medical Education and Research, Chandigarh. E-mail: [email protected]
Background: Pre-eclampsia, a syndrome peculiar endothelial dysfunction and vasoconstriction
to pregnancy is characterized by generalized manifested as proteinuria and increased blood
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
pressure. P selectin, a cell adhesion molecule is
elevated in many inflammatory conditions
including pre-eclampsia. The effect of vitamin E
supplementation on levels of soluble P-selection
in pre-eclampsia has been studied here.
Methods: Soluble P-selectin was measured by
commercially available ELISA kit. Vitamin-E
levels
in
plasma
were
estimated
spectrofluorometrically. Serum and urinary
creatinine as well as urinary protein were
estimated by commercial kits.
Results: In our study the effect of vitamin E (αtocopheryl acetate) supplementation of 400 IU/
day to patients of pre-eclampsia showed
significant decreased levels of soluble P-selectin
by the 2nd week as compared to patients given
placebo (p = 0.005). Vitamin E group of preeclampsia patients had baseline median P-selectin
level of 379 ng/ml, whereas, that of patients
receiving placebo was 363 ng/ml. By the end of
2nd week the values were 302 ng/ml and 380 ng/
ml respectively in both the groups.
Conclusion: Supplementation of 400 IU/day of
vitamin E for two weeks to patients with preeclampsia showed a significant decline in levels
of soluble P-selectin, a marker of inflammation.
In this short period of study no direct correlations
were observed between P-selectin levels and blood
pressure as well as with proteinuria.
Abstract No: 2.17
5-Methyl Tetrahydrofolate in Dried Blood Spot as an Indicator of Folate Status
in Humans
Thippeswamy.T.G., Ravinder Punjal and Madhavan Nair.K
Micronutrient Research Division, National Institute of Nutrition, Jamai-Osmania P.O., Hyderbad-500 007,
Andhra Pradesh, India, Email: [email protected]
Objective: Folic acid is a one-carbon donor
essential for growth and reproduction. Its
deficiency has not been mapped in India due to
lack of field friendly methods of blood collection
and estimation in the laboratory. Conventional
assays like microbiological and competitive
protein binding assay kits are sensitive but require
venous blood sample. In erythrocytes, folate exists
mainly
as
5-methyltetrahydrofolate
polyglutamates and therefore, the objective was
to develop a HPLC method for estimating 5Methyl tetrahydrofolate (5-MTHF) in dried blood
spots (DBS) and to establish as an indicator of
folate status.
Methods: Briefly, the methodology involved
quantitation of 5-MTHF in venous, DBS blood
124
samples and in plasma by HPLC. Stability of
5MTHF in DBS was also tested periodically.
Results: The results indicated that a minimum of
three DBS punches equivalent to 20µl of blood
was required for the analysis. The minimum
detection limit of 5-MTHF was 20 pg .The
recovery of added 5MTHF in the DBS sample was
more than 70%. The inter and intra-assay
variations were found to be less than 10%.
Conclusion: Although there was a good correlation
(r2 = 0.87) between the DBS and blood 5-MTHF levels
estimated by HPLC and folic acid estimated by
commercial kit, folic acid levels were always higher
compared to 5-MTHF. The relation ship between 5MTHF in DBS and folate status is being evaluated.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.18
Age Related Changes in Clcium, Phosphorous and Calcitonin in Healthy Women
with special reference to Premenopausal and Post menopausal Women
Miss V. Meenakshi, Dr.S.K. Sen and Dr. Roma Rattan
Background and objective: The data regarding
the effect of age on biochemical variables relating
to bone and mineral metabolism in healthy women
is inadequate. This leads to great hurdle for
initiating preventive measures in age related
osteoporosis in women. Though studies have
examined the role of serum calcium level in
osteoporosis in women, the role of age on serum
calcium and anti resorptive hormone calcitonin
in pre and postmenopausal women has not been
elucidated. Hence the study was designed to
evaluate serum calcium, phosphorous and
calcitonin in the healthy women.
Results: Serum calcium and calcitonin decreased
significantly as compared with control group
(p<0.001). Significant positive correlations were
found between serum calcium and calcitonin
(r=0.887, p<0.01). Serum calcitonin showed a
negative correlation with serum phosphorous (r=
-0.569, p<0.01). Similarly strong negative
correlation was found between serum calcium and
phosphorous(r=-0.603, p<0.01).
Conclusion: Serum calcium and calcitonin starts
to decrease in women with age greater than 40yrs
and plunges to low level in post menopausal and
Methods: The study included healthy women
senile women. These findings will help in initiate
(n=161) aged 30-90 years. Serum calcium and
phosphorous were measured in Dade Behring auto the measures in women at an earlier age to prevent
analyzer. Serum calcitonin was estimated by ELISA. osteoporosis.
Abstract No: 2.19
Effects of Resveratrol on Expression of Critical Bone Remodelling Factors in
Surgical Menopause Model of Rat
Alka Khera, Dr. Thungapathra M, Dr. Jaswinder Kalra and Dr. Sujata Ghosh
Objective: To investigate the molecular
mechanisms of protection conferred by resveratrol
against estrogen deficiency induced osteoporosis,
using surgical menopause model of rat.
Methods: The study was conducted on three
months old Sprague Dawley (SD) rats which were
given resveratrol (0.7 and 5mg per Kg diet) for 1
month. The rats were randomly divided into six
study groups each comprising 7 animals each. (i)
sham operated control group(ii) ovariectomized
(iii) ovariectomized treated with á -estradiol (iv)
sham operated treated with resveratrol (0.7mg/Kg
diet) (v) ovariectomised treated with resveratrol
(0.7 mg/Kg diet) (vi) ovariectomised treated with
resveratrol (5 mg/Kg diet).At the end of 1 month ,
blood was collected to estimate serum osteoclastic
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
and osteoblastic parameters. Femur was also
removed and its proximal end was used to extract
RNA and protein. Quantitative analysis of
estrogen receptor áβ vitamin D receptor (VDR),
parathyroid hormone receptor was done at gene
and protein levels in all the groups.
animals we observed an increase in the expression
of ERα, ERβ and VDR in resveratrol treated
animals. The expression levels of PTHR which is
an osteoclastic factor, decreased in experimental
animals as compared to control animals.
Conclusion: Resveratrol has protective role in
Results: Concomitant with the decrease in the curing osteoporosis caused by estrogen deficiency
levels of osteoporotic markers in resveratrol by directly affecting the expression of critical
treated animals as compared to ovariectomised factors involved in bone remodelling.
Abstract No: 2.20
An Experimental Evaluation of Cytoprotective Effect of Amifostine on CHOP
Chemotherapy in Albino Rats
Ambili Remesh
Dept. of Pharmacology & Therapeutics, Azeezia Medical College, Kollam;
E-mail: [email protected]
Background: Chemotherapeutic agents are in
combination and in conjunction with surgery,
radiotherapy and immunotherapy are used widely
for the treatment of variety of neoplastic diseases.
Drug toxicity to normal organs is a major obstacle
which prevent the use of optimal doses and
schedules.. Cytoprotective agents like Amifostine
constitute a novel group of agents which when
administered prior to chemotherapy protects
normal tissues from the deleterious effects of
chemotherapy with out attenuating the antitumour
response.
Objectives: The main objective of the
experimental study was to assess the effect of
toxicity induced by CHOP chemotherapy in albino
rats and histopathologically demonstrate the
protection of vital organs by Amifostine on druginduced toxicities.
Methods: Normal albino rats (weighing150250gm) were randomly assigned to three groups.
Group1 (control group) received no drugs. Group
126
2 was given CHOP regimen (dose) and group 3
was administered Amifostine prior to CHOP
chemotherapy. General signs and changes in
behavioural, neurological, autonomic profile are
noted. Haematological investigations were done
and weight changes were noted. Then animals
were undergone euthanasia under ether anaesthesia
and histopathological examinations of internal
organs were carried out.
Results: Statistical data analyses were done for
haematological investigations and weight changes.
The level of significance was fixed at 5%.
Conclusion: Study demonstrated that Amifostine
has cytoptrotective effect in CHOP chemotherapy
induced toxicity. There is a BIOCHEMICAL
BASIS for this CYTOPROTECTION which is
depicted in the mechanism of action of Amifostine.
The present study further signifies the need for
thorough knowledge of cell biochemistry in novel
drug development for cytoprotection.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No.2.21
Biochemical Changes in Acute Organophosphorus Poisoning
Indira A Hundekari, *A.N.Suryakar, Nilima N. Dongre, J G Ambekar, B.B.Devaranavadagi
and D.B.Rathi.
BLDEU’s Shri B.M. Patil Medical College ,Bijapur, Karnataka. *V.M.Govt. Medical College ,Solapur,
Maharashtra, Email ID- [email protected]
Introduction: Organophosphorus poisoning is
a major global health problemwith more than
200,000 deaths every year. Organophosphorus
compounds are widely used worldwide in
agriculture as well as in most household gardens
.Unfortunately because of their easy availability
and potent toxicity, there is a gradual increase
in accidental poisoning and is commonly abused
for suicidal purpose.
Hospital and Research Centre, Bijapur.The
samples were analyzed using standard methods
for different biochemical parameters.
Results: Progressive fall in plasma
cholinesterase and increased serum
malondialdehyde levels in correlation with the
severity of organophophorus poisoning were
observed. There was significant decrease in
serum total cholesterol and potassium levels
without much change in sodium level. C-reactive
protein levels were increased. Serum magnesium
levels were decreased in organophosphorus
poisoning cases as compared to control group.
Objectives: Toxicities of organophosphorus
compounds cause oxidative damage of cell
membranes and also result in disturbed
biochemical and physiological functions. Hence
we planned to study the biochemical changes
in acute organophosphorus poisoning.
Conclusion: Inhibition of cholinesterase leads
Methods: Blood samples were collected from to increased acetylcholine level which induces
the clinically diagnosed organophosphorus oxidative damage resulting in various
changes
during
acute
poisoning subjects admitted during the year biochemical
2007-2009, in Shri B.M. Patil Medical College organophophorus poisoning.
Abstract No: 2.22
Lead Toxicity Among Automobile Workers
Nilima N. Dongre*, A.N.Suryakar,**A.J.Patil,I.A.Hundekari,**J.A.Patil,J.G.Ambekar
B.B.Devaranavadgi, D.B.Rathi and ***Rama Jailkhani
BLDEU’s Shri B.M.Patil Medical College,Bijapur,Karnataka. * Dr.V.M.Govt.Medical
College,Solapur,Maharashtra. ** Krishna Institute of Medical Sciences,Karad,Maharashtra. *** SDM
Medical College,Sattur Dharwad Karnataka. Email ID : [email protected]
Introduction: In developing countries like India
lead poisoning still occurs.Automobile workers
are prone to long term lead toxicity due to their
routine works such as motor vehicle assembly,
spray painting, burning of petrol, welding, brazing,
battery recharging or replacing and radiator repairing.
Objectives: Occupational lead poisoning is well
documented .No such study has been reported from
this area. Hence the aim of the study is to observe
the lead induced toxic effects among the
automobile workers in the lead based workplaces
from Bijapur city.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: A study on toxic effects of occupational
lead exposue among 27 automobile workers and
25 nonexposed healthy controls from Bijapur city
was carried out. Lead levels in the blood and urine
were analysed by atomic absorption
spectrophotometer and standard assay procedures
were used for other biochemical parameters.The
biochemical parameters studied were serum
bilirubin,total protein,albumin, globulin,A/G
ratio,gamma-glutamyl transferase, alanine
transaminase,aspartate transaminase,alkaline
phosphatase, urea,creatinine and uric acid.
lead levels were significantly increased in the
automobile workers. as compared to nonexposed
healthy controls (P<0.0001). It is also observed
that there is significant change in some liver
function and kidney function tests in automobile
workers.
Conclusion: The study indicates lead toxicity still
persists in automobile workers .The study helps
to create awareness about the toxic effects of lead
and may entail establishment of regulations for the
precautionary measures to be taken among the lead
exposed workers.
Results: The study shows that blood lead and urine
Abstract No: 2.23
Tacrolimus in Renal Transplant Recipients
Dr.Pradeep Naik, and Mallikarjuna .M
Department of Clinical Biochemistry, Global hospitals, Hyderabad, Email : [email protected]
Objective: AUC-guided dosing of tacrolimus
prevents progressive systemic overexposure in
renal transplant recipients. Tacrolimus has a
narrow therapeutic drug and bioavailability is
known to vary considerably between renal
transplant recipients. Most of the transplant centers
still rely on measurement of trough levels, but
there are conflicting reports on the correlation
between tacrolimus trough levels and systemic
exposure, as measured by the area-under-theconcentration-over-time curve (AUC(0-12h)).
high concentration in 14 patients[ 99 % ] the
squared correlation with the AUC (0-12h) (r 2=
0.94).the concentration of four hours post-dose
blood is proportional to the increase of the drug
dosage .
Results: Compared with trough level monitoring
only, this approach reduced the 95%-prediction
interval by 50%. The Bayesian approach proved
to be feasible in clinical practice, and provided
accurate information about systemic tacrolimus
exposure in individual patients. In the AUC-guided
Methods: We studied and analyzed in 15 renal dosing cohort the apparent clearance of tacrolimus
transplant recipients - based pharmacokinetic decreased gradually over time, which was not
model with ELISA use of TMB as a substrate to reflected in corresponding trough levels.
estimation of tacrolimus systemic exposure.. The
main objective was to study intrapatient variability Conclusion: This simple, flexible method provides
in the drug concentrations in blood versus different the opportunity to predict immunosuppression, and
doses. Bayesian forecasting with a two-point should help minimize tacrolimus-related toxicity,
sampling strategy, a trough level, and a second such as nephrotoxicity and post-transplant diabetes
sample obtained four hours post-dose significantly mellitus.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.24
Biochemical Effects of Feeding Soft Drink and Ethanol
Arun Raj, Praveen Kottath Veetil, Sheeba Varghese, J K Mukkadan and P K Joseph
Little Flower Institute of Medical Sciences and Research, Angamaly 683 572, India;
Email ID: [email protected]
Objectives: This work was undertaken to study
whether consumption of alcoholic beverage mixed
with soft drinks could reduce the metabolic effect
caused by ethanol.
Methods and results: When 24 hr fasted rats were
intragastrically fed rum (with 40% ethanol) diluted
(1:1) with water, 3.0 ml (0.5 g ethanol) per 100 g
body weight and sacrificed 12 hr later in fasting
condition, exhibited higher levels of triacyl
glycerol, glucose, total cholesterol, high density
lipoprotein (HDL), aspartate amino transferase
(AST), alanine amino transferase (ALT) and
alkaline phosphatase (ALP) in serum, higher
levels of total cholesterol, triacyl glycerol and
thiobarbituric acid reactive substances (TBARS)
in both liver and kidneys, and lower levels of
serum albumin. When fasted rats were fed 3.0 ml
soft drink (0.31 mg caffeine), they showed
increased levels of triacyl glycerol, glucose, ALT
and ALP in the serum, TBARS in liver and kidneys,
triacyl glycerol and total cholesterol in kidneys and
lower levels of serum albumin. Soft drink feeding
did not reduce serum total cholesterol but reduced
HDL levels. Also soft drink did not alter liver
lipids. When a mixture of 1.5 ml diluted rum (0.25
g ethanol) and 1.5 ml soft drink (0.154 mg caffeine)
were fed to the fasted rats, the serum parameters
increased similar to rats fed rum only except that
total cholesterol and HDL cholesterol were
unaltered. TBARS in kidneys and liver were also
increased but triacyl glycerol levels were not
altered.
Conclusion: Thus feeding ethanol with soft drink
does not reduce the metabolic effects of ethanol
but it will prevent ethanol induced serum HDL
cholesterol rise.
Abstract No: 2.25
Comparative Study for Slow Acetylator Status by Phenotype / Genotype
Polymorphism of N-acetyltransferase-2 in Patients on Antitubercular Treatment
S.V.Rana, Sanjeev K.Sharma, R. P. Ola, S.Arora*, S.K.Sinha, P Pandhi** and K.Singh
Departments of Gastroenterology , Immunopathology* & Pharmacology**, Postgraduate Institute of
Medical Education and Research, Sector 12, Chandigarh–160012, UT, INDIA.
Background: Isoniazid and rifampicine are
traditionally used as first line therapy for
tuberculosis. Acute hepatitis frequently develops
in patients receiving these drugs. Isoniazid is the
major drug incriminated in this hepatotoxicity and
mainly metabolized to hepatotoxicity
intermediates by N-acetyltransferase-2
(NAT2).Slow acetylators have been reported more
prone of hepatotoxicity. However, acetylator status
of a patient can be measured in blood
phenotypically by Isoniazid load test and
genotypically by NAT2 gene polymorphism. But
phenotypically measurement can be affected by
many other factors but easy to measure and does
129
Indian Journal of Clinical Biochemistry Supplement, 2009/24
not require PCR and electrophoreses and more
time.
fast acetylators measured by phenotypically using
Isoniazid load test. While only 20 out of 184
(12.2%) were slow acetylators and 160 out of 184
Objective: The present study was focused to (87.8%) were fast acetylators genotypically using
compare the results of both the methods in patients a PCR with RFLP of gene NAT2 polymorphism.
on antitubercular treatment.
These results shows that slow acetylators were
Methods: One hundred eighty four adult North more when measured phenotypically as compared
Indians between age 18-65 yrs were enrolled in to genotypically.
this study. Measurement of slow acetylator Conclusion: This study indicates that
phenotypically was done by Isoniazid load test and genotypically estimation of slow acetylator status
genotypically by NAT2 gene polymorphism in in patients on antitubercular treatment using NAT2
patient’s blood by PCR-RFLP method.
polymorphism can not be replaced by
Results: Out of 184, forty-four patients (26.8%)
were slow acetylators and 140 out of 184 (73.2%)
phenotypically measurement of slow acetylators
using isoniazid load test.
Abstract No: 2.26
Correlation of Gall Stone Disease with Iron-Deficiency Anemia
1
Prakash A; 1Lal A.K; 2Sachan P.K and 2Sahu S.K.
Department of 1Biochemistry and 2Surgery, Himalayan Institute of Medical Sciences, Jollygrant,
Dehradun, Email: [email protected]
Introduction: Gallstone disease is a common
clinical entity affecting the adult population of
both sexes. There are many causes for the disease.
The one main important cause may be the iron
deficiency anemia. So our main study was to
correlate iron deficiency anemia with gallstone
disease.
Methods: 100 patients suffering from
cholelithiaris admitted in our hospital with
confirmed diagnosis by ultra sonography were
included in the study irrespective of their age, sex
and parity. Serum Iron, serum total Cholesterol
and biliary Cholesterol was estimated in all the
patients. Based on serum iron content, the patients
with choleslithiasis were divided into two groups.
Group A contained patients with normal serum
iron and Group B iron deficient patients. Serum
130
and biliary cholesterol contents of both groups
were analyzed and compared with each other.
Results: The mean bile cholesterol level in Group
A was found to be 214.6 mg/dl and in Group B it
was 375.3 mg/dl. The difference in values in both
the groups was found to be statistically extremely
significant (P<0.0001). Iron deficiency has been
shown to alter the activity of several hepatic
enzymes leading to increased gall bladder
cholesterol saturation and promotion of cholesterol
crystal formation.
Conclusion: The present study suggests that iron
deficiency anemia is playing a significant role in
the super saturation of gallbladder bile with
cholesterol and may act as an independent factor
in formation of cholesterol gallstones.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.27
Trace Elements in Leprosy
Dr V B Londhe, Sevarina Madhale*, Dr Z G Badade**, Dr P E Jagtap***,and Dr S K Ahaley****
Assoc. Professor, Biochemistry Dept., JNMC, Belgaum, *Jr. Research Fellow, RLH, Miraj, ** Prof.
& Head, Dept. of Biochemistry, MGM Medical College, Navi-Mumbai, *** Prof. & Head, Dept. of
Biochemistry, Bharati Vidyapeeth’s Medical College, Miraj, **** Professor of Biochemistry, Bharati
Vidyapeeth’s Medical College, Miraj. [email protected]
Background: Leprosy (Hansen disease) is a
chronic infections disease of man caused by
mycobacterium leprae. Trace elements play an
active role in various metabolic processes of the
body. In recent years there has been an enormous
awareness and understanding of role of trace
elements in health and disease. Trace elements
catalyse and control biochemical reactions. More
than half of the body enzymes have one or more
of trace elements incorporated at their active sites,
many enzymes depend upon association with trace
elements for their activity.
matched healthy subjects were selected from Civil
Hospital, Sangli and Richardson leprosy Hospital,
Miraj. The trace elements viz. Zn, Cu, Mn, Mg,
and Se were estimated by Atomic Absorption
Spectophotometry, at USIC, Shivaji University,
Kohlapur and vanadium was estimated by ISE
method at NCL, Pune.
Results: In our study as per increase in bacillary
load the oxidative stress increased in different types
of leprosy. Trace elements viz., Zn, Mn, Mg, Se
and V decreased, while Cu increased as sialylated
ceruloplasmin increased in peripheral blood.
Objective: The aim of our study was to explore
Conclusion: The trace elements zinc, copper,
the role of trace elements in the leprosy.
manganese, magnesium, selenium and vanadium
Methods: In present study fifty clinically may act as biochemical markers in diagnosis,
diagnosed leprosy patients and fifty age and sex differentiation and prognosis of leprosy.
Abstract No: 2.28
Oxidative Stress, Antioxidants and Trace Elements in Leprosy
Dr V B Londhe, Sevarina Madhale*, Dr Z G Badade**, Dr P E Jagtap***and Dr S K Ahaley****
Assoc. Professor, Biochemistry Dept., JNMC, Belgaum, *Jr. Research Fellow, RLH, Miraj, ** Prof.
& Head, Dept. of Biochemistry, MGM Medical College, Navi-Mumbai, *** Prof. & Head, Dept. of
Biochemistry, Bharati Vidyapeeth’s Medical College, Miraj, **** Professor of Biochemistry, Bharati
Vidyapeeth’s Medical College, Miraj. [email protected]
World wide leprosy continuous to be a major public problem. Leprosy is an infectious disease and
occurs principally in developing countries. Mycobacterium leprae is a causative organism of lep-
rosy. At present, 1.3 million people are suffering
from leprosy. Less attention has been paid towards
free radical, antioxidant and trace elements study
in leprosy. Considering these facts our study was
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
aimed to find out correlation between oxidative
stress, antioxidants enzymes and trace elements
in leprosy. In present study fifty clinically diagnosed leprosy patients and fifty age, sex matched
healthy subjects were selected from Civil Hospital, Sangli and Richardson Leprosy Hospital,
Miraj. Serum lipid perode, SOD, Catalase and
glutathione peroxidase were estimated by spectrophotometric methods. The trace elements viz.
Zn, Cu, Mn, Mg, and Se were estimated by Atomic
Absorption Spectophotometry, at USIC, Shivaji
University, Kohlapur and vanadium was estimated
by ISE method at NCL, Pune. In our study, with
extent of disease progression, the oxidative stress
increased, due to increase in the bacillary load.
For scavenging purpose, the trace elements Zn,
Mn, Mg, Se and V with their respective antioxidant enzymes SOD, GPx and Catalase decreased.
Antioxidant enzymes and trace elements showed
negative correlation with lipid peroxide and bacillary load. There was positive correlation between copper and lipid peroxide with bacillary
index. The estimation of LPO, SOD, GPX, catalase and trace elements serum Zn, Cu, Mn, Mg,
Se and V as biochemical markers for diagnosis
and prognosis of leprosy.
Abstract No: 2.29
Variations in Serum Ferritin, Electrolytes and TIBC Levels in Paediatric
Multitransfussed Thalassemic Patients
Jaidev Singh, Dr. (Mrs) Meena Varma and Dr.Sangeeta Paneri
M.G.M Medical College Indore (M.P). Email ID: [email protected]
Introduction: Beta thalassemia is a single gene
disorder requiring regular multi-blood transfusion
which causes serious side effects an overload of
iron in the form of ferritin.Excess or free iron can
catalyze the formation of very toxic compound
such as OH- radicals through Fenton reaction
which causes oxidative damage. This oxidative
damage causes the pathogenesis of the membrane
abnormalities observed in beta thalassemia..
healthy control.All were in the age group of 3-10
Objective: We determined whether thalassemia
could account for abnormal cation transport
system. Traditionally serum iron, ferritin, TIBC
and the % saturation, an indirect measurement of
transferrin, have been used to determine iron
status.
levels were found to be significantly decreased in
Methods: In the present study included 75
multitransfused thalassemic children and 35
responsible for observed changes of electrolytes
132
years. And evaluated the serum ferritin by ELISA
METHOD, electrolytes by Flame photometry,
TIBC by RAMSAY DIPYRIDYL method
Results: In the present work it was found that, the
significantly increased serum levels of ferritin
while normal mean levels of TIBC in thalassemia
patients as control group. The serum Na+ & K+
thalassemic patients respectively.
Conclusion: It can be concluded that the increased
& decreased or normal TIBC are related to
thalassemia. And defective membrane transport is
homeostasis in thalassemia.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 2.30
Study of Lead Content in Various Water Samples within Bangalore and A Survey
Based on Effects of Lead Poisoning on People
Preeti Mangala*, Javeria Anjum and Arpi Dey
*Department of Chemistry, Jyoti Nivas College (Autonomous), Bangalore-560095, India,
email: [email protected] (Dr. Preeti Mangala, Lecturer in Chemistry, Jyoti Nivas College
(Autonomous), Bangalore, Ms. Javeria Anjum, Student of III B.Sc. (Biotech, Botany, Chemistry),
Jyoti Nivas College, Bangalore, Ms. Arpi Dey, Student of III B.Sc. (Biotech, Botany, Chemistry),
Jyoti Nivas College, Bangalore)
Objective: Water is an essential component for
survival of life on earth. We require water for each
and every activity that we do. The source of lead
in water can be domestic, environmental and
occupational. Keeping in mind the above sources,
it was considered worthwhile to investigate few
water samples from residential areas like
Koramangala and BTM Layout (near to our
college), lakes such as Ulsoor, Madiwala, Agara
etc. and area where there is battery recycle units
such as Tilaknagar for the lead content.
Methods: The estimation of lead content in about
41 water samples was done by Graphite Furnace
Atomic Absorption Spectrometry (GFAAS)
method followed by comparative studies. For
residential areas, the comparison was between
source (treated water/Cauvery water) and kitchen
based on plumbic and non-plumbic supply of
Cauvery water, mixing of Cauvery water with
bore- well water etc. For lake water, the influential
factors were disposal of wastes, immersion of
painted Ganesha idols if any and rain. The amount
of lead was relatively high in the water samples
contaminated through occupational sources as
expected.
Results: The result shows that bore-well water
of Koramangala (especially 7th & 8th Block) has
more lead content than Cauvery water. This may
be due to presence of printing press, automotive
repair shops, industrial machinery etc. around or
plumbic fixtures or fittings in those residences.
Further, mixing of Cauvery water to bore-well
water reduces the lead content. The relatively
greater lead content of Koramangala water tank
may be due to degrading PVC pipes, hard plaster,
lead paints, tile & brick glaze, seals for water mains
etc. The experimental data proves that the borewell and some of the well water are contaminated
with a very little amount of lead in the residential
area of BTM Layout which may be due to
construction of building/flyover, demolition of old
houses, painting, plumbic fixtures and fittings,
pottery, industrial machinery work etc. It is
noteworthy to mention that the lead content in
various water samples of Cauvery water reported
in this project were found to be appreciably small
and it can be regarded as ‘Lead-safe water’. The
significant decrease of lead content in the water of
Ulsoor, Madiwala and Agara lakes from May 2008
to September 2008 may be due to dilution as a
result of heavy rain. This also attributes to the ban
of immersing the painted Ganesha idols in the lakes
of Bangalore city after the holy festival of ‘Ganesha
Chaturthi’ and promoting the eco-Ganesha which
is a great achievement of the entire team of
National Referral Centre for Lead Poisoning in
India (NRCLPI) and Quality Council of India
(QCI) for conducting several awareness
programmes/workshops related to prevention of
lead poisoning in various schools/colleges within
the city. The relatively high lead contamination of
133
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Tilaknagar well water reported here may be due of Biochemistry, St. John’s National Academy of
to occupational lead exposure like breaking, Health Sciences, Bangalore for awarding this short
recycling and manufacturing batteries.
term research project; to Dr. S. Muralidhar Rao,
Sr. Manager – Technical Operations,
Conclusion: The overall result was found to be Aquadiagnostics (AWRTCL), Bangalore in
within desirable maximum limit according to analysing the lead content by GFAAS method; to
W.H.O. (50 ppb or ìg/L), but we must further Dr. P.A. Shankar, Director, Filtrex Technologies
alleviate lead for “lead-safe water”.
Pvt. Ltd., Bangalore for discussion on research
Acknowledgement: We are thankful to Dr. methodology, and to Sr. Philomena Cardoza,
Thuppil Venkatesh, Director (NRCLPI, Advisor Principal. Jyoti Nivas College (Autonomous),
of Quality Council of India (QCI), Professor, Dept. Bangalore for her support and financial assistance.
Abstract No: 2.31
Evaluation of Lead Concentration in Milk and Milk Products
Charanraj T.P1*, Anuj Ranjan, Alka Kumari, Arun Kumar, Kalpana Devi.N and Sushma Bharti
1.Department of Biochemistry, Reva Institute of Science and Management. Bangalore.
Email: [email protected]
Twenty five milk samples were collected from
different places using acid treated Lead free polyethylene bottles and evaluated for the concentration of Lead using AOAC method of extraction
and assayed by Graphite furnace atomic absorption spectrophotometer (GFAAS).The data
showed that Lead is present in diversified con-
centrations among the milk samples obtained from
different regions. The current study revealed that
the Lead concentration in some places of study is
above the WHO limits (0.02ppm or 20 ppb).The
current study was conducted during monsoon.
Seasonal fluctuations if applicable have not been
included
Abstract No: 2.32
Effect of Lead on Employees Working in Paint Industry
Hariprasad.B.N, Vinay.G, Vinay Kumar.C, Sathish Kumar.P, V and Prof. Sripathy.L
HOD of Chemistry; Vivekananda Degree College, Department Of Chemistry, Dr. Rajkumar Road,
Rajajinagar, Bangalore-55
Under the guideines: Dr. Venkatesh Thuppil, Principal advisor QCI & NRCLPI
Awareness about the toxic effects of heavy metals
(LEAD) is still lacking in developing countries.
Lead is one among them, which ranks second in
the Agency for Toxic Substances and Disease
Registry’s top 20 lists of toxic metals. There is
still one source of lead regularly causing poisoning, namely paint, on which this paper focuses.
134
Lead poisoning has been known for centuries.
Childhood poisoning from lead–based paints was
first noted in 1897 in Australia, where children ate
paint chips from porch railings this prompted the
City of Brisbane to pass specific legislation designed to prevent poisoning from lead–based paint.
Lead concentration of blood samples from paint
Indian Journal of Clinical Biochemistry Supplement, 2009/24
industries were determined by meta-exchange reagent followed by Anodic Stripping Voltammetry
method. The main aim of this study is to determine the blood lead level of the employees working in Paint industry, from in and around Peenya
industrial area (Bengaluru), to asses the feasibility of using the lead in paints. Some of the paints
being used even now are known to contain this
toxic metal at alarming levels. We have a list of
persons who are quite often suffered from headaches and back aches. Lead is mainly used in
paints for speeding up its drying, & for giving them
desired colors. A wide range of colors contain lead,
for instance, Yellow contains Lead (II) chromate
i.e. PbCrO4, White color contains lead (II) carbonate, PbCO3. The Blood lead level is ranging
from 9.4 to 26.7. Correlating with the values of
control it was found that there is a considerable
rise in the blood lead level. Concluding, the employees in the paint industry have the Blood lead
level at alarming levels.
Abstract No: 2.33
Vitamin D- Emerging Silent Lifestye Disease: A Pilot Study
D. Radhika Chowdary and B. Naveen Kumar
Department of Laboratory Medicine, Krishna Institute of Medical Sciences; Secunderabad-500003
Aim: To estimate the 25 hydroxy vitamin D levels
in patients coming to outpatient department with
generalized musculo skeletal pains and muscle
cramps.
by Phosphomolybdate reduction on Vitros 250 dry
chemistry analyzer.
Results: Out of 128 patients 91 (67%) were
Vitamin D deficient with normal calcium and
Objective: To establish a relationship between phosphorus levels. Mean of vitamin D 15.07 ± 7.51
µg/dl, phosphorus 3.66 ± 0.61 mg/dl and calcium
vitamin D deficiency and the generalized
9.59 ± 0.70 mg/dl in these deficient individuals.
symptoms which were not due to any other
specific cause for which they were investigated. Discussion: There was deficiency of vitamin D in
The deficiency of vitamin D leads to bone pains 67 % of the patients with normal Calcium &
& fractures, muscle cramps and in severe cases Phosphorus levels. The deficiency seems more
osteomalacia. The threshold for optimum Vitamin prevalent than thought in tropical country like India
D status is known to be considerably higher than where sunlight is adequate. Deficiency may be due
to too little time spent outdoors & tendency to
that required to prevent osteomalacia.
switch to vegetarian diet where Vitamin D is very
Methods: Random venous samples of 128 low. Detection of Vitamin D levels and treatment
patients were taken from Jan to June 2009 for with it alleviates most of the symptoms. However
estimation of Vitamin D,calcium & phosphorus this is only a pilot study with patients coming to
levels. Vitamin D was estimated on Elecyses our hospital. We need to take up different
Roche 2010 by electro chemiluminescence. population study based on activity, socioeconomic
status & lifestyle for more detailed data.
Calcium was estimated by Arsenazo, phosphorus
135
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.1
Myeloperoxidase in Chronic Kidney Disease
Usha Anand, Madhusudhana Rao.A, Vijaya.D, Aruna V, Gayathri.B and Anand C.V
Department of Biochemistry, PSG Institute of Medical Sciences & Research, Coimbatore-641004.
Email: [email protected]
Background: Myeloperoxidase (MPO), a prooxidant enzyme is released from granules of
activated neutrophils at inflammatory sites. High
levels of MPO have been implicated in the
pathogenesis of CVD. As chronic kidney disease
(CKD) is a risk factor for CVD, we attempted to
estimate levels of MPO in patients with CKD
including end-stage renal disease (ESRD).
Methods: Subjects of this study were classified
into three groups based on GFR which was
calculated using MDRD formula. Group I
consisted of control subjects (n=20) with normal
kidney function and a GFR > 90 ml/min/1.73m2.
Group II and III included patients with CKD.
Group II (n=30) had GFR between 15 and 89 ml/
min/1.73m2 while group III (n=25) had ESRD and
GFR < 15 ml/min/1.73m2. Plasma MPO was
assayed by a spectrophotometric method. Serum
urea and creatinine were estimated on a clinical
chemistry analyzer using standard laboratory
procedures.
Results: Plasma MPO levels progressively
lowered with advancing renal failure. Plasma MPO
levels (U/L) were 62.07 ± 19.76, 46.68 ± 20.03
and 28.73 ± 12.50 (mean ± SD) in groups I, II and
III respectively. MPO levels were significantly
lower in groups II and III when compared with
group I (p<0.05). There was a significant positive
correlation between GFR and MPO (r = +0.458,
p<0.001) and a significant negative correlation
with urea (r = -0.410, p<0.01) and creatinine (r = 0.456, p<0.001).
Conclusion: Contrary to assumption, MPO levels
decline with progression of CKD. Decline in
plasma MPO levels may be due to the inhibitory
effect of uremic toxins on the enzyme.
Abstract No: 3.2
Serum Adenosine Deaminase Levels in Acute Kidney Injury
Saleena Ummer V1, Nalini K2 , Ravindra Prabhu3 and Licy CD1
1
Dept. of MLT, MCOAHS-Manipal, 2Dept. of Biochemistry, 3Dept. of Nephrology, Kasturba Medical
College, Manipal University
Background: Adenosine deaminase (ADA) is a
non-specific marker of the T cell activationand
hence important in acute and protracted
inflammatory responses. Inhibitors of ADA can
attenuate the elevation of pro-inflammatory
136
factors. However the effect of ADA in renal
dysfunction has not been adequately studied.
Objective: The purpose of this study was to
correlate the activity of serum ADA in patients with
Indian Journal of Clinical Biochemistry Supplement, 2009/24
acute kidney injury (AKI) and to establish a group .ie, 63.41±11.56 IU/L vs 23.39 ± 5.22 IU/L
relationship between ADA activity and AKI if any. with a p value of <0.001. Any correlation between
serum ADA activity and creatinine level could not
Methods: Serum ADA activity was determined be established.
in 28 cases with AKI. These patients were
diagnosed with sepsis, leptospirosis and snake Discussion: Although serum levels of ADA do not
bites. 25 healthy individuals served as controls. correlate with that of creatinine, its serum level is
Serum creatinine levels were estimated (by Jaffe’s increased in AKI with a higher positive predictive
method) to confirm the kidney injury. ADA value. Many effects produced by ADA are caused
activity was determined by Guisti and Glanti’s by the metabolism of adenosine. It is known that
(colorimetric) method. The cut off value was taken adenosine can attenuate the ischemic/reperfusion
as 35 IU/L. The ADA activity was compared in injury. If adenosine is rapidly metabolized by the
patients with AKI with that of healthy controls. high level of ADA, the beneficial effects of
Correlation analysis between serum ADA activity adenosine will be lost. This would result in the
and creatinine level was also performed.
production of superoxide radicals thereby
exaggerating kidney injury. However to study the
Results: Out of the total 28 cases of AKI, 17 precise mechanisms involved, further
showed an elevated serum ADA activity. Mean characterization of the enzyme and determination
serum ADA levels were significantly higher in of its cellular source is essential.
those with acute kidney injury than in the control
Abstract No: 3.3
In vitro Studies on Anticalcifying Properties of achyranthes aspera
Aggarwal A*, Singla SK** and Tandon C*
*
Department of Biotechnology and Bioinformatics, Jaypee University of Information Technology,
Waknaghat, Solan – 173215, **Department of Biochemistry, Panjab University, Chandigarh
Objective: Kidney stone is one of the oldest and
most widespread diseases known to man. Calcium
containing stones, especially calcium oxalate
monohydrate (whewellite), calcium oxalate
dihydrate (weddellite) and calcium phosphate
(apatite) are the most commonly occurring ones.
The present study is aimed at examining the
efficacy of Achyranthes aspera on mineralization,
growth and demineralization of Calcium
Phosphate in vitro.
to study its anticalcifying properties. For initial
mineralization of calcium phosphate, a 5ml assay
system containing 0.05M Tris HCl (pH 7.4), 5mM
CaCl2, 5mM KH2PO4 and aqueous extract was
prepared. After incubation and centrifugation, the
pellet was dissolved in 0.1N HCl for estimation of
calcium and phosphate.
Results: The growth and demineralization assays
were performed using the preformed mineral
phase. Calcium and phosphate estimations were
Methods: The roots of Achyranthes aspera were performed in the pellet and the supernatant for the
powdered and the aqueous extract was prepared growth and demineralization assays respectively.
by boiling the sample, and then filtering it. This Achyranthes aspera was found to inhibit
aqueous extract obtained after filtering was then mineralization and demineralization of calcium
used as a test sample for the various assay systems and phosphate in vitro in a concentration dependent
137
Indian Journal of Clinical Biochemistry Supplement, 2009/24
manner. Aqueous extract of Achyranthes aspera
also inhibited the growth of calcium and phosphate
on preformed mineral phase.
Conclusion:
Based on experimentally
demonstrated properties, Achyranthes aspera is a
valuable candidate for developing new
phytotherapeutic agents.
Abstract No: 3.4
Correlation of Serum Intact Parathormone Level with Biochemical Parameters in
Various Stages of Chronic Renal Failure Pateints
Bhimappa N.M, Suma M.N and H.S Virupaksha
E-mail: [email protected]
Background:
The
secondary
hyperparathyroidism is a common, important and
treatable complication of chronic renal
insufficiency (CRI) and end-stage renal disease
(ESRD). Although its exact pathogenesis is not
known, hyperphosphatemia, hypocalcemia,
deficiency of vitamin D, decreased expression of
calcium and vitamin D receptors, and parathyroid
hormone (PTH) resistance have individual roles.
Longstanding secondary hyperparathyroidism
results in osteitis fibrosa cystica (a high turnover
bone lesion) and increases the risks for bone pain
and fractures.
Objectives: 1.To estimate serum intact
parathormone and other biochemical parameters
like serum creatinine, blood urea, serum calcium
and inorganic phosphate in chronic renal failure
patients and healthy volunteers. 2.To compare
serum intact parathormone level with biochemical
parameters in chronic renal failure patients and
healthy volunteers. 3.To find if there is any
correlation between serum intact parathormone
level and biochemical parameters in the study
group.
Methods: 30 patients in each stage of chronic
138
renal failure (totally 150 CRF patients) and 30
healthy controls in the age group of 20-60 years
were taken for the study. Serum intact
parathormone (iPTH) was estimated by
chemilumino-metric assay, serum total calcium by
Arsenazo-III method, serum inorganic phosphate
by ammonium molybdate method, blood urea by
urease method and serum creatinine by Jaffe’s
method. Creatinine clearance was calculated using
Cockcroft and Gault equation.
Results: The level of serum iPTH was significantly
higher in more advanced renal failure, thus
confirming the relationship between severity of
hyperparathyroidism and the degree of renal
impairment. The increased levels of mean serum
iPTH were present even in early renal failure, and
it was related to low mean serum calcium level
and progressive rise of serum inorganic phosphate
from early to advanced renal failure. So serum
iPTH is negatively correlated with creatinine
clearance (GFR) and serum total calcium.
However, serum iPTH is positively correlated with
inorganic phosphate, urea and creatinine. Thus
progressive hypocalcemia and hyperphosphatemia
are the initiating factors for the development of
secondary hyperparathyroidism in CRF patients.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.5
Comparison of Serum Creatinine, Urinary Creatinine and Urinary Beta 2
Microglobulin Levels as an Early Marker of Subtle Renal Dysfunction due to
Aminoglycoside Therapy in Full Term Sick Neonates.
Dr Bonny B Jasani, Dr Rohini Bhadre and Dr Varsha D. Phadke
Dept of Biochemistry, Second floor, Hospital building, K.J.Somaiya Medical College and Research
Centre, Eastern Highway,Everad nagar, Sion Mumbai - 400022,Maharashtra, Email Id:
[email protected]
Objective: Comparison of serum creatinine,
urinary creatinine and urinary beta 2
microglobulin levels as an early marker of subtle
renal dysfunction due to aminoglycoside therapy
in full term sick neonates.
Methods: In this prospective randomised case
control study sixty six full term sick neonates
admitted in NICU of a tertiary hospital from
December 2007 to November 2008 requiring
aminoglycoside treatment and thirty normal
neonates matched appropriately were enrolled in
the study. Apart from routine septic profile, the
parameters to assess renal function included serum
creatinine, urinary creatinine and urinary Beta 2
microglobulin which were estimated on day of
admission and on Day 3, Day 7. The investigations
done in controls were urinary Beta 2
microglobulin on Day 1 and Day3 of life. All sixty
six full term sick neonates were administered
cefotaxime and gentamicin or amikacin alternately
for duration of minimum seven days.
Results: In our study, the percentage of renal
dysfunction diagnosed by serum creatinine was
28% and by urinary beta 2 microglobulin was 68%.
This signifies that 40% of the neonates with subtle
renal dysfunction would be missed if traditional
tests are used in diagnosis. It also revealed that
though Beta 2 microglobinuria is an extremely
sensitive indicator of proximal tubular dysfunction,
it was a relatively insensitive test to diagnose
aminoglycoside nephrotoxicity due to coexistence
of underlying clinical conditions in sick neonates.
Conclusion: Beta 2 microglobinuria is a sensitive
and early indicator of proximal tubular function
but its clinical utility in diagnosis of
aminoglycoside nephrotoxicity is limited due to
presence of multiple confounding factors.
Abstract No: 3.6
Observations on Microalbuminuria in Hypertensives with Alcholism and / or
Smoking
Dr.D.L.Lalitha1, Dr.B.Sreehari babu2, Mr.D.S.S.K.Raju2 and Dr.P.K.Behera3
1.Associate Professor, 2. Tutor, 3.Professor, Department of Biochemistry, MIMS, Nellimarla,
Vizianagaram, A.P; Email ID: [email protected]
Methods: 60 cases of hypertensive patients were
selected who were negative for albustix in urine
and were assessed for incidence of
microalbuninuria with reference to their habits of
smoking and alcoholism. Out of 60 hypertensive
patients 46 (77%) were found to have
microalbuminuria.
Prevalence
of
microalbuminuria in males and females were found
139
Indian Journal of Clinical Biochemistry Supplement, 2009/24
to be 77% and 75% respectively in those 46 cases.
48 normal healthy individuals who were not
hypertensive and were non-alcholics and nonsmokers constituted the control. The twenty-four
hours urine samples were collected and stored with
preservative. The urinary microalbumin was
estimated by using pyrogallol method (Pointe
scientific,inc..USA) Microaluminuria was also
calculated in terms of albumin/creatinine ratio
(mg/g).
Results: In the present study microalbuminuria
in controls and hypertensives was found to be
19.02mg/day±5.25 and 77.08mg/day±37.35. The
increased microalbuminuria in hypertensives was
statistically significant (p<0.001). Albumin
creatinine ratio in controls and cases were found
to be 14.44 mg/g±4.62 and 57.62mg/g±30.66
respectively. The increase of albumin creatinine
ratio in hypertensives was also found to be
statistically significant (p<0.001). Prevalence of
microalbuminuria in nonsmokers and nonalcoholic
hypertensives was found to be 14%. However the
prevalence in alcoholics, smokers and both smoker
& alcoholic groups were found to be 22%, 32%
and 32% respectively. The mean urinary
microalbumin level in smokers, alcoholics,
smokers&alcoholic and nonsmoker &
nonalcoholic groups were found to be 97.22mg/
day, 89.66 mg/day, 122.66 mg/day and 80.5 mg/
day respectively. The alcoholics and smokers
exhibited statistically significant (p<0..001) higher
level for microalbumin as compared to other
groups. These findings suggest both smoking and
alcholism adversely affects the renal functions.
Conclusion: Thus it becomes immensely
important in respect of therapeutic implementation
and educating the hypertensives regarding the ill
effects of smoking and alcoholism
Abstract No: 3.7
Serum Lipoprotein(a) and Lipid Profile in Chronic Kidney Disease
Neela B M, and Virupaksha H S
Department Of Biochemistry, J.S.S Medical College, Mysore, Karnataka; Email
Background: Chronic kidney disease is
characterized by progressive loss of renal function.
Cardiovascular disease is the leading cause for
morbidity and mortality in these patients.
Lipoprotein(a) [Lp(a)] is a cholesterol rich particle
existing in the human plasma. In chronic kidney
disease patients, lipoprotein(a) level is increased.
Increased lipoprotein(a) level is risk for
cardiovascular disease.
Objectives: 1.To estimate serum lipoprotein(a) in
chronic kidney disease patients. 2.To estimate total
cholesterol, HDL-Cholesterol, LDL-Cholesterol
and triglyceride levels. 3. To compare the above
with age and sex matched healthy controls. 4. To
study if there is any correlation between
140
lipoprotein(a) and cholesterol, triglyceride, LDLCholesterol and HDL-Cholesterol.
Methods: The study group included 30 patients
diagnosed as chronic kidney disease patients and
30 healthy controls. Serum lipoprotein(a) was
estimated. Total Cholesterol, Triglyceride, LDLCholesterol, HDL-Cholesterol were correlated
with lipoprotein(a) levels.
Results and Discussions: There was significant
increase in lipoprotein(a) level in patients with
chronic kidney disease when compared to controls.
Increase in lipoprotein(a) level was statistically
significant. Increased Lp(a) level along with
increased triglyceride, LDL-Cholesterol could lead
to the accelerated tendency of atherosclerosis and
other cardiovascular abnormalities in these patients.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.8
Evaluation of Urinary Protein Bound Sialic Acid and Protein Carbonyl content as
the Prognostic Markers of Nephrotic Syndrome in Pediatric Age Group
Niranjan.G, Koner B.C and Bhat .V
Department of Biochemistry and pediatric , JIPMER; Email ID: [email protected]
Introduction: Nephrotic syndrome (NS) is a
common disorder affecting mainly the pediatric
age group, 90% of the NS cases are idiopathic
which can be classified as steroid sensitive (SS),
steroid dependent (SD) and steroid resistant (SR)
cases depending on response to treatment with
steroids. There is no way to predict at the onset
which cases are going to be SS, SD or SR cases.
Hence the present study was designed to find out
if urinary protein bound sialic acid (UPBSA) and
urine protein carbonyl content (UPCC) differ in
SS, SD or SR cases of NS and also to find out
estimation of these parameters before starting the
treatment can predict the prognosis of these cases.
Methods: 70 NS cases were enrolled in the study.
UPBSA and UPCC were estimated by
modifications in Aminoff’s and Levine’smethods
respectively in all the cases before starting the
steroid treatment. Later all the cases were followed
up out of which 47 cases became SS also we also
got 15 SD and 8 SR cases.
Results: Both UPBSA and UPCC s were
significantly low in SS compared to SD and SR
cases. ROC showed a cutoff limit of 2.74 µgm/mg
for UPBSA and 7.02 n moles/mg protein for UPCC
to predict SD/SR cases of NS.
Conclusion: Urinary protein bound sialic acid and
urinary protein carbonyl content can be used as a
marker to predict SS, SR and SD cases of NS.
Abstract No: 3.9
Oxidative Stress and Transforming Growth Factor-Beta 1 (TGF-â1) in the
Progression of Diabetic Nephropathy
Kavitha Gandhi* and Dr.Rita Mary Aruna**
*
Vinayaka Mission’s Medical College, **Penang International Dental College, Salem;
E-mail: [email protected]
Objectives: To study the correlation of glycated
hemoglobin, total antioxidant status (TAS) and the
level of TGF-â 1 in Type II Diabetic patients with
renal disease.
Methods: The study was conducted on sixty
patients with Type-II Diabetes Mellitus, who
attended as outpatient department in Madurai
Kidney Research Centre, from January-2009 to
March-2009. Group I: 26 Diabetic patients without
nephropathy (Subgroup IA: 8 patients with good
glycemic-control (HbA1C<7%), Subgroup IB: 18
patients with poor glycemic control (HbA1c>7%).
Group II: 34 Diabetic patients with nephropathy
(Subgroup IIA: 16 patients with good glycemic
control (HbA1c<7%) and Subgroup IIB 18 patients
with poor glycemic control (HbA1c>7%), Group
III: 10 healthy controls. We measured plasma TGF141
Indian Journal of Clinical Biochemistry Supplement, 2009/24
â1, TAS and correlated its level with different
biochemical parameters.
correlation with HbA1c (r=0.4154, p<0.01),
creatinine (r=0.2777, p<0.05). Additionally there
was a negative correlation between the HbA1c and
Results: Our results showed a statistically
TAS (r=-0.500, p<0.01). Our results suggest that
significant decrease in TAS in all diabetic patients
TGF-â1 plays a key role in the development and
when compared to controls (p<0.05). TGF-â1 is
progression of diabetic-nephropathy and therefore
statistically increased in poor glycemic-control
apart from glycemic-control and decreasing
group of diabetic patients with nephropathy and
oxidative-stress, strategies aiming at antagonizing
without nephropathy than the control. There was
TGF-â1 by the use of a specific-inhibitor of TGFa negative correlation between plasma TGF-â1
â1 may helpful to prevent the development or
and the TAS (r=-0.4168, p<0.01), and positive
attenuate the progression of diabetic-nephropathy.
Abstract No: 3.10
Hypothyroidism and Renal Impairment
*K.Shanthi Naidu, **M.R.Chakravarthi, #Bipin Kumar Sethi, *Suryadeep Pratap, *Syed Hyder
Ali, *BVLN Murthy and *G.Surekha
Departments of * Laboratory Medicine, ** Consultant Nephrologist, # Consultant Endocrinologist,
CARE Hospital, Banjara Hills, Hyderabad – 500034, Andhra Pradesh
Objective: Knowledge of association between
thyroid dysfunction and renal impairment is now
an established fact and should be an essential and
integral part of evaluation.
Methods: The study was conducted
retrospectively in hundred samples of renal
dysfunction. A control group of both sexes 30 to
70 years considered as normal reference for serum
creatinine and TSH. The study group included inpatients (34) and out-patient (66). Assays were
processed on Beckman Coulter Synchron Cx9 and
Access
Results: The clinical presentation of renal
impairment was exhaustively studied for an
etiological
factor
which
identified
hypothyroidism. 80% had elevated creatinine
implying renal impairment, of which 75% were
142
identified with an abnormal TSH. This small study
reveals that severe hypothyroidism may
masquerade as renal impairment. Mildly elevated
creatinine showed TSH values well above 300
mIU/ml. The identification and treatment soon
reduced the renal impairment in terms of lowered
serum creatinine and urine protein creatinine ratio
along with improvement in the thyroid status.
Conclusion: TSH should be considered when
evaluating patients of renal impairment of
unknown etiology. The cause of renal failure in
hypothyroidism may be explained by (i) decreased
renal plasma flow due to a hypodynamic state and
in severe cases can be (ii) secondary to
rhabdomyolysis.
Acknowledgements: Nephrology, Endocrinology,
Cardiology and Intensive Care Units.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.11
Oxidative Stress and Antioxidant Therapy in Nephrotic Syndrome
Jyoti Dwivedi 1 and Dr.Purnima Dey Sarkar 2,
1
Deptt. of Biochemistry, S.S. Medical College Rewa (M.P.) 486001 India. 2 Deptt. of Biochemistry,
N.S.C.B. Medical College Jabalpur (M.P.) India
Results: In the present study observed there were
significant decreased level of serum total
antioxidant capacity, copper, zinc, plasma vitamin
C and increased serum level of malondialdehyde,
homocysteine, in group 3 when compared group1.
However
significant
reduction
in
malondialdehyde, homocysteine and significant
improvement in serum total antioxidant capacity,
copper, zinc & plasma vitamin C were observed
Objective: The aim of the present study was to after antioxidant, minerals & B-complex therapy
estimate the serum total antioxidant capacity, with routine prescription in group 2 when
malondialdehyde, homocysteine, copper, zinc, compared to group 1.
plasma vitamin C during remission and
Conclusion: In the present study oxidative stress
complication.
is higher in secondary nephrotic syndrome than
Methods: The present study was conducted on 3 nephrotic syndrome. The study further reports
groups, group1 comprised of 50 pretreated beneficial effects of antioxidants, minerals and Bnephrotic syndrome patients, group 2 comprised complex vitamins on oxidative stress in nephrotic
of 50 post treated nephrotic syndrome patients and syndrome patients may prolong need for treatment
group 3 comprised of 41 secondary nephrotic of nephrotic syndrome and secondary nephrotic
syndrome patients. Serum total antioxidant syndrome patients.
capacity, malondialdehyde, homocysteine, copper,
zinc, plasma vitamin C were analyzed.
Background: The free radicals have a negative
influence on renal tissue in nephrotic syndrome.
Nephrotic syndrome is a consequence of an
imbalance oxidant/antioxidant status. Hyperhomocyst(e)inemia induce oxidative modification in
nephrotic syndrome. Zinc and copper deficiency
in nephrotic syndrome related to increase urinary
zinc and copper losses.
Abstract No: 3.12
Serum Cystatin C levels in Renal Transplant Recipients
Krishnamurthy N 1, Usha Anand 2, Anand C V 2, Aruna V 2, and Venu G 3
1
Department of Biotechnology, Sathyabama University, Chennai, India. 2 Department of Biochemistry
and 3 Department of Nephrology, PSG Institute of Medical Sciences and Research, Coimbatore, India.
e mail: [email protected]
Objective: Serum creatinine (SCr) is a traditional
parameter which is widely used for the assessment
of renal function. Serum cystatin C (SCys) is an
emerging parameter which has been proposed as
an early indicator renal dysfunction. This study
was carried out to compare the performance
characteristics of these two parameters in renal
transplant recipients (RTR).
Methods: SCr and SCys were estimated using
standard laboratory techniques in 30 RTR.
Glomerular filtration rate (GFR) was calculated
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
from SCr using MDRD formula and from SCys
using the Le Bricon formula.
The calculated GFR values are also indicative of
mild renal failure.
Results: Values are expressed as mean ± S.D. The
SCr level was 1.257 ± 0.316 mg/dL which is
indicative of normal renal function. In contrast,
the SCys level was 1.401 ± 0.256 mg/L which is
higher than the reference range (0.52 – 1.1 mg/
L). The calculated GFR based on MDRD was
65.46 ± 16.37 ml/min/1.73m2 while the GFR based
on Le Bricon was 61.59 ± 11.12 ml/min/1.73m2.
Conclusion: Creatinine is removed not only by
glomerular filtration but also by tubular secretion.
Cystatin C on the other hand is removed
exclusively by glomerular filtration. Levels of
SCys therefore rise with even mild decreases in
GFR. To conclude SCys is a more sensitive and
reliable marker of mildly impaired renal function
in renal transplant recipients when compared with SCr.
Abstract No: 3.13
Serum Zinc and Serum Copper Level in Renal Diseases
Payasvi Baweja*, B.K Agrawal *, and V.K Sharma**
* Department of Biochemistry, ** Department of Medicine, Gandhi Medical College, Bhopal,
E-mail:[email protected]
Objective: Human body contains about 3.07%
metals, of which Zinc and Copper are known to
be essential factors for growth and development
of living things. Its values are found to undergo
alterations in various renal diseases.
Hypozincemia and Hypocuperemia is found in
Nephrotic Syndrome. This study was undertaken
to estimate values of Serum Zinc and Copper in
renal diseases.
highly significantly decreased (P<0.001) in
Nephrotic Syndrome and Glomerulonephritis
patients, while in UTI patients it is significantly
decreased (P<0.01) as compared to control group.
Serum Copper level was highly significantly
decreased (P<0.001) in Nephrotic Syndrome,
while in Glomerulonephritis and UTI patients there
is no significant difference (P>0.05) as compared
to controls.
Methods: The present study included 54 renal
patients and 15 healthy controls matched in terms
of Serum Zinc and Copper level by colorimetric
method, Akita Abe, Yiamashita, S., (1989), crest
biosystems. Results: The Serum Zinc level was
Conclusion: It can be concluded that serial Serum
Zinc values are required as an index of prognostic
value in renal diseases and estimation of Serum
Copper is important diagnostic tool in cases of
Nephrotic Syndrome.
Abstract No: 3.14
Renal Function Screening in Neonatal Asphyxia
Prachi Paliwal,* Dr.B.K.Agrawal,** Dr.Rashmi Dwivedi,***and Dr.Paliwal Manoj****
Gandhi medical college Bhopal (M.P), Mrs. Prachi Paliwal; Email- [email protected]
Objective - Birth asphyxia occurs when a baby
does not receive enough oxygen before, during or
just after birth. Target organs of perinatal asphyxia
144
are the kidneys, lungs, brain, liver, gut and bone
marrow. The most frequent abnormalities involve
Kidneys (50%), CNS (28%), lungs (23%) and so
Indian Journal of Clinical Biochemistry Supplement, 2009/24
on. High blood urea and serum creatinine values
are associated with renal failure. We performed
this study to determine the incidence of renal
failure in birth asphyxia and to correlate the
severity of renal failure with asphyxia.
By –:
Estimating serum creatinine level in neonatal
asphyxia, : Estimation of blood urea nitrogen, :
Determination of blood urea nitrogen / creatinine
ratio on I, III & VII day of life, : And total urine
output within 24 hrs.
Methods- The study included 50 asphyxiated and
25 healthy neonates. Renal functions were
assessed using urinary output and biochemical
parameters such as blood urea by Urease
GLDH method and serum creatinine by Jaffes
kinetic method.
Results- Blood urea and serum creatinine were
significantly higher in asphyxiated babies
compared to control groups (p<0.001). Blood Urea
nitrogen / Creatinine ratio was significantly higher
in asphyxiated babies compared to control groups
(p<0.001) on day 3 but insignificant on day 1.
There was no significant difference in the urine
output in the control and the study group. Majority
of asphyxiated neonates had non-oliguric renal
failure.
Conclusion- We conclude that renal failure is a
significant problem in asphyxiated neonates. A
high level of Urea & Creatinine on III rd day of
study is associated with renal failure in asphyxia.
Despite tremendous advancements in medicine,
treatment of ARF has remained essentially
supportive. Birth asphyxia is still common, more
so in developing countries where obstetric and new
born resuscitation facilities are not universally
available yet. Combination of dehydration, shock,
sepsis and nephrotoxic drugs is not an uncommon
situation in NICU.These lead to high incidences
of neonatal renal failure. They are often reversible
if identified and managed in time.
Abstract No: 3.15
Exploring the Role of Lipids Isolated from Human Renal Stone Matrix in Urolithiasis
Priyadarshini1, Shrawan Kumar Singh2 and Chanderdeep Tandon1
1
Biotechnology & Bioinformatics, Jaypee University of Information Technology, Waknaghat, H.P.,
India, 2Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Background: Organic matrix of calcium oxalate
stones
consists
of
protein,
lipid,
glycosaminoglycans etc. It is suggested that
presence of these biomolecules in stone organic
matrix is related with the formation of renal
calculi. There are many proteins which are
reported to exhibit inhibitory or stimulatory
activity against kidney stone formation, for
example Tamm-horsfall protein, osteopontin etc.
However, only few studies have been done on the
activity of lipid biomolecules on kidney stone
formation.
Methods: Surgically removed calcium oxalate
stones were first confirmed by FTIR analysis,
washed with 0.15M NaCl and then pulverized.
Powdered calcium oxalate was extracted with ice
cold chloroform: methanol: 0.05M Tris HCl pH7.4
(2:1:1); using sonication at 4ÚC. Upper and lower
phases were removed separately and pooled as
aqueous and organic substances after
centrifugation. Organic phase was extracted with
ethanol: ether (3:1) and then centrifuged.
Complexed lipids present in pellet were dissolved
in DMSO by sonication and were used to check
Objective: Therefore, lipid biomolecule(s) were their activity on calcium oxalate (CaOx) crystal
chosen to evaluate their activity on the process of nucleation and growth.
kidney stone formation.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Results: The lower volumes of complexed lipids
showed inhibitory activity whereas stimulatory
activity was observed with their higher volumes
when it comes to the nucleation of CaOx crystals.
However, complexed lipids present in the organic
matrix of CaOx kidney stones exhibited inhibitory
activity against the CaOx crystal growth assay
system.
Abstract No: 3.16
Prevalence and Characterization of Renal Tubular Acidosis in Patients with
Myalgias, Osteoporosis and Mild Arthritis.
Rachel Jacob
Department of Biochemistry, NIMS, Hyderabad.
Background: Overt metabolic acidosis is
undoubtedly associated with metabolic bone
disease, but the prevalence of metabolic acidosis
in mild osteoporosis and arthritis is uncertain.
Chronic metabolic acidosis may also manifest
with musculoskeletal symptoms of varying
degrees.
Objective: It was purposed to identify the
prevalence of renal tubular acidosis in patients
suffering with chronic myalgias, mild osteoporosis
and mild arthritis.
Methods: Review of hospital data 2001-2008,
revealed 52 patients with complaints of myalgia,
muscle weakness, joint pains and/or arthritis.
Ammonium chloride load test (0.1g/kg body
weight) was done to establish renal acidification
defect. Screening for immune-mediated disorders
was done. Blood and urine chemistries, arterial
blood gas analysis were done to identify
electrolyte imbalance. Osteoporosis was assessed
by nuclear scan.
Results: Thirty-four (65%) cases were identified
to have an acidification defect(M-14, F-20), 31 had
distal tubular acidosis (dRTA) and 3 of proximal
RTA. Forty percent of the women were in the
menopausal and post-menopausal phase.
Neuromuscular weakness associated with
hypokalemia was evident in 76% while
osteoporosis and bone disease was confirmed in
74%. Metabolic acidosis was seen in 88% with
low serum bicarbonate and normal to mild acidosis
was noted in 6 cases. One case each of Sjogrens,
Vitamin-D resistant rickets, inflammatory arthritis,
renal calculus and renal osteodystrophy were
identified.
Conclusion: RTA can be a major cause of myalgias
and joint pains with or without weakness. Women
around the menopausal period need to be evaluated
for RTA. Normal blood pH or mild acidosis
warrants further investigation to avoid missing
incomplete dRTA.
Abstract No: 3.17
Renal Calculi Analysis
K.Shanthi Naidu, Suryadeep Pratap, Zaheed Khan, Syed Hyder Ali, S.M.Ismail and A.Phani Kumar,
Department of Laboratory Medicine, CARE Hospital, Banjara Hills, Hyderabad – 500034, Andhra Pradesh
Objective: Renal calculi analysis is a necessity
as the identification of constituent indicates the
“type of stone”, which is a guide to treatment and
146
prevention of recurrence. Renal stones can cause
urinary tract infection, damage the kidney and
cause obstruction.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: During a period of six years 197 renal
calculi were analyzed. The incidence was seen
from 18 to 74 years, predominantly males. The
physical features of a stone is important in
relevance to its size, weight, colour, texture which
have been variable. Biochemical colour reactions
of calcium, phosphorus, oxalic acid, magnesium,
cysteine, uric acid, carbonate, xanthine were done
on the powdered stone material.
that of phosphorus in combination with oxalate,
magnesium, xanthine and cysteine. Only a single
constituent was seen as a xanthine stone.
Conclusion: In all these patients a complete
examination of renal and metabolic status with
special reference to aminoacidurias, parathyroid
hormones disturbances which may lead to altered
calcium phosphorus metabolism are essential to
be known, as appropriate treatment and preventive
Results: Calcium was seen in nearly 80% of the measures rely on the etiological factor of the stone.
stones, its combination being as high as 79.4%
with phosphorus 27%, carbonate 15.7%, urate Acknowledgement: Departments of Nephrology
28.4%, magnesium 44.2%, cysteine 6.8% and & Urology
xanthine 12.6%. The second largest variety was
Abstract No: 3.18
Antioxidant Activity of Creatinine and Uric Acid and Related Efficacy of Antioxidant
to Inhibit Glycation
Rohit Suresh*, Yogita S Phapale* and Dr. Z.G Badade**
*P.G.Student, **Professor & Head, Department of Biochemistry, MGM Medical College, Kamothe,
Navi-Mumbai, Pin-410 209; [email protected]
Background: Non enzymatic glycation, the
reaction of glucose and other reducing sugars with
protein, reversibly produces amadori products and
over a long period irreversibly advanced glycation
end product (AGE) are formed. These AGE
products contribute to the pathogenesis of diabetic
complication. Recently in vitro AGE formation
from glucose and albumin were found to be due
in part to the oxidants.
Objective: The aim of our study is to investigate
the antioxidant property of creatinine and uric acid
and the inhibition potency of the antioxidant on
the formation of AGE products in vitro. In vitro
glycation was studied with bovine albumin as the
model protein.
Advanced glycation products were quantified by
measuring the protein carbonyl content by Levin
et al method. Uric acid and creatinine were used
as potent inhibition of glycation mixture. Using
the same range of concentration used for inhibition
of AGE products, uric acid and creatinine were
assessed for antioxidant property by reducing
power assay. Both antioxidant activity and
inhibition of glycation in vitro show a positive
correlation.
Results: In our study we found that uric acid and
creatinine decreased the amount of AGE products
in vitro.:
Conclusion: These results underline the
importance of uric acid and creatinine as
Methods: Albumin was glycated in glucose/ therapeutic agents for the prevention of diabetic
fructose mixture by thermal glycation method. and age related complications.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.19
Carbamylated Haemoglobin: A Diagnostic Marker for Chronic Renal Failure.
S.Subramaniam, ShyamaSubramaniam, M.K. Mani*, Partha Karmakar*, K.Ezhil arasan,
K.Dhananjayan and M.Gopinath
Department of Biochemistry, Apollo Hospitals, Chennai – 600 006. * Department of Nephorology,
Apollo Hospitals, Chennai – 600 006.
Background: Carbamylated Haemoglobin is
formed by the reaction of haemoglobin with
cynate : a product of in-vivo urea dissociation. It
is found in high level in patients with renal failure
and may be useful in their clinical evaluation.
Creatinine, Hb, GlycoHb and Carbamylated Hb.
Carbamylated Hb levels were determined in blood
samples by HPLC Method using Bio-Rad: D10
GlycoHb Analyser.
Results: Two peaks were seen in control and Acute
Objective: To find whether carbamylated Renal Failure patients, whereas only one peak was
Haemoglobin can be used as a marker for seen in Chronic Renal Failure patients. If we use
the cut off of carrbamylated Hb level 60 u/g Hb,
diagnosis of chronic renal failure.
then the sensitivity becomes 88.5%, specificity
Method: Blood samples were collected from 28 (100%) and Positive predictive Value (100%).
normal renal function (Control), 26 Acute renal
Failure patients (ARF), 27 Chronic Renal Failure Conclusion: D10 Glycosylated Haemoglobin
patients(CRF) with Diabetic nephropathy and 29 analysis graph having a single peak for
Non Diabetic nephropathy Chronic Renal Failure Carbamylated Haemoglobin can be used as a
Patients. Samples were used for analysis of Urea, reliable marker in identification of CRF.
Abstract No: 3.20
Evaluation of Low Dose Doxycycline on Renal Function in Diabetes with
Nephropathy
S. Seth, P. Talapatra, H.K. Aggarwal and M. Seth
Department of Biochemistry, Medicine & Pharmacy , Pt.B.D.Sharma PGIMS, Rohtak,
E-mail ID : [email protected]
The study was conducted in forty clinically proven
adult cases of Diabetic Nephropathy (Proteinuria
>300mg/24 hrs) attending Kidney and Dialysis
Clinic at PGIMS, Rohtak. All patients were on
stable dose of ACE inhibitors and / or ARB for
two months prior to study. Forty patients were
divided in two groups. Group-I – Patients on insulin / oral hypoglycemic drugs + ACE inhibitors
and /or ARB alone. Group-II – Patients on insulin / oral hypoglycemic drugs + ACE inhibitors
and /or ARB alongwith Doxycyclin (100 mg/day)
148
for three months. There was a significant decrease
in Proteinuria (urine proteins were estimated by
Biuret method) in both the groups when compared
to the basal levels. The decrease in group-II was
highly significant but the levels returned to the
basal levels on stoppage of the drug. There was
no alteration in renal biochemical parameters like
blood urea, serum creatinine, serum uric acid, serum calcium and serum phosphate. The probable
mechanism of action of Doxycyclin in improving the renal function will be discussed.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.21
The Effects of Kidney Function and Transplantation on Plasma Electrolytes,
Albumin and Cardiovascular Risk
Thompson, M.J.W.1 and Ray, U.1,2
University of Tasmania, Hobart, Australia1; Royal Hobart Hospital Hobart, Tasmania, Australia2.
Background: Chronic kidney disease (CKD) is Results: Plasma phosphate, magnesium and
an increasingly common disease that greatly potassium increased in direct proportion to degree
increases risk of cardiovascular disease (CVD), of kidney impairment (all p<0.0001), whereas
particularly coronary artery disease. Risk of CVD albumin and calcium decreased (p<0.0001).
is directly proportional to degree of kidney Kidney transplantation resulted in an immediate
impairment and greatest in end stage kidney reduction in phosphate, magnesium (both
disease (ESKD). As CKD progresses, the effect
of traditional risk factors such hyperlipidemia on
cardiovascular mortality decreases and the effects
of novel risk factors such as vascular ossification
and hypoalbuminemia increases. Accordingly,
clinical trials using traditional interventions such
as statins have thus far failed to show a benefit.
Optimal treatment for ESKD is kidney
p<0.0001) and potassium (p= 0.014). These
reductions were maintained long term (all
p<0.0001). There was no immediate change in
calcium (p=0.34) or albumin (p=0.42), however
over a longer time period both increased
significantly over pre-transplantation levels
(p<0.0001).
transplantation, which is known to improve Conclusion: Kidney impairment resulted in
survival over maintenance dialysis.
disordered calcium, magnesium and phosphate
Aim: To examine the effect of kidney metabolism, which predisposes to vascular
transplantation on plasma electrolytes & albumin ossification and increases CVD risk. Kidney
to see whether this contributes to the survival impairment was associated with raised potassium,
advantage of kidney transplant recipients over pro-arrhythmogenic contributing to mortality.
those on maintenance dialysis.
Methods: We conducted a retrospective cohort
study of 48 patients (M = 29, F = 19; Age = 2484) receiving a kidney transplant at the Royal
Kidney transplantation produced an immediate,
significant improvement in magnesium, phosphate
and potassium levels, which was maintained long
term. Significant improvements in plasma
Hobart Hospital within the last 10 years. electrolyte homeostasis and albumin
Biochemical profiles immediately pre- and post- concentrations may contribute to the survival
transplantation and over the longer term were advantage conferred by kidney transplantation over
maintenance dialysis.
analysed.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.22
Tacrolimus in Renal Transplant Recipients
Dr. Pradeep Naik and Mallikarjuna.M
Department of Clinical Biochemistry, Global hospitals, Hyderabad; Email id: [email protected]
Objective: AUC-guided dosing of tacrolimus
prevents progressive systemic overexposure in
renal transplant recipients. Tacrolimus has a
narrow therapeutic drug and bioavailability is
known to vary considerably between renal
transplant recipients. Most of the transplant centers
still rely on measurement of trough levels, but
there are conflicting reports on the correlation
between tacrolimus trough levels and systemic
exposure, as measured by the area-under-theconcentration-over-time curve (AUC(0-12h)).
high concentration in 14 patients[ 99 % ] the
squared correlation with the AUC (0-12h) (r 2=
0.94).the concentration of four hours post-dose
blood is proportional to the increase of the drug
dosage .
Results: Compared with trough level monitoring
only, this approach reduced the 95%-prediction
interval by 50%. The Bayesian approach proved
to be feasible in clinical practice, and provided
accurate information about systemic tacrolimus
exposure in individual patients. In the AUC-guided
Methods: We studied and analyzed in 15 renal dosing cohort the apparent clearance of tacrolimus
transplant recipients - based pharmacokinetic decreased gradually over time, which was not
model with ELISA use of TMB as a substrate to reflected in corresponding trough levels. This
estimation of tacrolimus systemic exposure.. The simple, flexible method provides the opportunity
main objective was to study intrapatient variability to predict immunosuppression, and should help
in the drug concentrations in blood versus different minimize tacrolimus-related toxicity, such as
doses. Bayesian forecasting with a two-point nephrotoxicity and post-transplant diabetes
sampling strategy, a trough level, and a second mellitus.
sample obtained four hours post-dose significantly
Abstract No: 3.23
Study of Microalbuminuria in Hypertension
Sharma, Ashutosh. (1); Lal, A.K. (1); Mehrotra, V. (1) and Verma, S.K. (2)
Department of (1) Biochemistry and (2) Medicine, Himalayan Institute of Medical Sciences, Dehradun,
INDIA. Email: [email protected]
Background: ‘Save the Kidney’ was theme for
2004 given by WHO with the assurance that every
hypertensive patient be screened for nephropathy.
Microalbuminuria is associated with glomerular
damage and endothelial dysfunction which leads
to development of nephropathy. Nephropathy, if
150
left untreated can lead to serious complication such
as kidney failure because albumin molecules are
relatively small; it is often among the first proteins
to enter the urine after the glomeruli damage. So,
even minor kidney dysfunction should be detected
with proper diagnosis of microalbuminuria.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Objective: In our study the effect of hypertension
on the incidence and frequency of
microalbuminuria has been evaluated and
correlated with other renal biochemical
parameters.
Methods: 60 patients of hypertension of both
sexes between 27 to 76 years of age were studied
and 20 controls were also included Blood tests
(sugar, urea, creatinine and total cholesterol) and
urine analysis (protein, sugar and microalbumin
was done.
Results: Urinary microalbumin was significantly
raised in cases of hypertension. A positive
correlation was found between the age and urinary
microalbumin levels and serum cholesterol and
urinary microalbumin. Similarly creatinine and
BUN was raised although within normal range in
cases of hypertension with raised urinary
microalbumin. It is apparent that the earliest sign
of nephropathy in hypertensive patients is
microalbuminuria. It is conclude that Nephropathy
is a common complication of hypertension and rise
in the levels of urinary microalbumin is an early
indicator for the development of nephropathy.
Abstract No: 3.24
The Pattern of Nephrotic Syndrome in Malabar region, Kerala
K Sreevidya and George Abraham
A.W. H. Special College, Calicut and Malabar Institute of Medical Sciences, Calicut.
Email : [email protected]
Objective: Nephrotic syndrome or nephrosis is a
group of symptoms of kidney malfunction with
typical clinical features associated with plasma
protein changes such as hypoalbunemia,
hyperalbuminuria, hyperlipidemia, hyperlipiduria
and edema. There is a geographical variation in
the prevalence and pattern of this disease. This
disease is mainly seen in children and young
adults. Earlier studies conducted revealed a high
prevalence of this disease in children in India
Subcontinent and South East Asia. Protein
electrophoresis is a good screening procedure to
evaluate the major serum proteins. This method
is extensively used as a diagnostic and prognostic
tool for facilitating diagnosis of various diseases,
especially nephritic syndrome.many diseases. In
this study the serum protein electrophoresis pattern
is evaluated using Agarose Gel electrophoresis
(Ready to use kit Hydragel Protein kit Supplied
by M/S Sebia, France).
Methods: A total of 20 serum samples of patients
with nephrotic syndrome and serum samples of
20 healthy age and sex matched controls were
included for the study. Serum total protein (Biuret
method), serum albumin (BCP Dye-binding
method) and serum cholesterol (Enzymatic HOD
– PAP method) were also estimated. Urine samples
of all the subjects were collected and analysed.
Results: There was a significant increase in serum
á – 2 globulin fractions and decrease in serum
albumin (P d” 0.01) in all patients when compared
with that of the normal controls. Decrease in alpha
1 globulin and increase in â globulin fraction is
seen in the patients especially in the juvenile group.
Decrease in serum albumin is predominant in male
patients compared to the females. An increase in
cholesterol and â globulin fractions was also seen
in patients, predominantly in the juvenile group.
Conclusion: The patients of this region presented
with lipoid pattern of nephritic syndrome. Contrary
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
to the finding of other part of the country, we found
more of the disease in adults and old age group (>
50 years). The etiology can be secondary nature,
contributed by progressing nephropathy resulted
from other diseases. Among our patients the most
interesting case was that of a lady with 80 years of
age presenting with a pattern of á – 2 â bridge on
the electrophoretogram with a cholesterol
concentration of 680 mg/dL, TG – 485 mg/dL and
a medium albuminuria (80 mg/dL).
Abstract No: 3.25
Adiponectin Levels in Chronic Kidney Disease and its Correlation with CRP,
Cystatin-C and eGFR
Manjunatha G.J and Vijay S. Bhat
Manipal Hospital, Old Airport road, Bangalore-560017
Background: CKD is a unique condition in that
exceedingly high incidence of insulin resistance,
which in turn associated with enhanced
cardiovascular events, is paradoxically associated
with elevated adiponectin.
Objective: Adiponectin, a 30kD collagen like
protein exclusively produced by adipocytes,
possessing anti inflammatory properties, a marker
of oxidative stress was taken up in this study which
consisted of patients in different stages of renal
disease. A correlative study of adiponectin with
markers of inflammation (CRP) and renal function
(Cystatin –C, eGFR & ACR) was done.
Results: There was no correlation between CRP
and adiponectin levels (p =0.267), There was an
inverse relationship between eGFR and
adiponectin (ìg/ml log transformed) (r = -0.364,
P < 0.001) and a direct relationship with ACR and
log transformed adiponectin(r = 0.42, p=0.006).
Cystatin–C was significantly higher in renal
transplant patients than in normal, independently
of serum creatinine & creatinine clearance. Higher
adiponectin levels were found with worsening
renal function and increasing Proteinuria.
Conclusion: It was observed that in renal
transplant patients and those with CKD, the level
Methods: Three categories of subjects were taken of adiponectin was nearly double that of baseline.
for the study, first group consisting of controls (15 It might be that an increased level of adiponectin
members), second group of CKD in various stages is directly involved in impairment of kidney
(24 members) and third group who have
function, due to their molecular weight. Follow
undergone renal transplant (12members). Plasma
up data would be invaluable in testing whether our
adiponectin was estimated by ELISA method. HSfindings are due to casual relationship, as the
CRP and Cystatin–C were Immunonephelometric
number of subjects taken in the study was minimal.
method. ACR was calculated by estimating urinary
It is not known whether this increase in adiponectin
albumin & creatinine, eGFR was calculated by
using the MDRD equation. Statistical analysis was reflects impaired adiponectin clearance by kidney
done by using Kruskal – Wallis one way analysis or whether it is a compensatory mechanism aimed
at counteracting increased CAD risk factors.
of variance and by ANOVA.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 3.26
Effect of Smoking on Chronic Renal Failure in Primary Glomerular Nephropathies
Prof.(Dr) Uday Kumar* Dr.A.Sharan** and Dr Snigdha***
* Prof & Head,**Additional Professor, Biochemistry,Igims,Patna..** Junior Resident, UCMS & GTBH, Delhi.
Background: Smoking is known risk factor for
renal damage in diabetic patients. To assess its
effect
in
primary
glomerular
nephropathy(PGN),we used data from a
case;control study designed to assess several
environmental risk factors.
[ 65%, OR=0.9(95% confidence interval 0.61.4)],but was significantly higher among cases with
CRF(75%) than those without [55%,OR=2.4(1.24.5)]. Dose effect relationships were observed with
both the daily and cumulative dose;this relationship
was stronger in the comparision of cases with CRF
and those without CRF than in the comparison of
cases with CRF with controls:OR=1.9 versus
1.3(</=20 cigrattes per day)and OR=5.2 versus
3.0(> 20 cigarettes per day): OR=1.9 versus 1.4(
</= 15 pac per years) and OR=3.9 versus 2.0( >
15 packs per year). Interactions between
age,hypertension and smoking were observed in
the risk of CRF: smoking was significantly related
to CRF among cases more than 40 years of age
and hypertensive.
Methods: The study included 148 biopsy proven
glomerular nephropathies of which were 40
membranous nephropathy,58 IgA nephropathy,
and 50 nephritic syndrome with either minimal
change nephropathy or focal segmental
hylinosis.It includes 121 matched hospital
controls,with diseases unrelated to smoking.
Smoking history was taken from all the subjects.
Chronic renal failure(CRF) ,defined by serum
creatinine >150 micro mol/L. was present in 37
cases( 28 men & 9 women). Logistic regression Conclusion: This study supports the hypothesis
was used to estimate odds ratios(ORS) adjusted that smoking is related to glomerular nephropathy
severity,particularly older persons of age group
for age and social status.
more than 40 and/or hypertensive.
Results: Percentage of ever-smokers did not differ
glomerular nephropathies cases(60%) and controls
Abstract No: 3.27
The Effects of Kidney Function and Transplantation on Plasma Electrolytes,
Albumin and Cardiovascular Risk
Thompson, M.J.W.1 and Ray, U.1,2
University of Tasmania, Hobart, Australia1; Royal Hobart Hospital Hobart, Tasmania, Australia2.
Background: Chronic kidney disease (CKD) is
an increasingly common disease that greatly
increases risk of cardiovascular disease (CVD),
particularly coronary artery disease. Risk of CVD
is directly proportional to degree of kidney
impairment and greatest in end stage kidney
disease (ESKD). As CKD progresses, the effect
of traditional risk factors such hyperlipidemia on
cardiovascular mortality decreases and the effects
of novel risk factors such as vascular ossification
and hypoalbuminemia increases. Accordingly,
clinical trials using traditional interventions such
as statins have thus far failed to show a benefit.
Optimal treatment for ESKD is kidney
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
transplantation, which is known to improve
survival over maintenance dialysis.
Objective: To examine the effect of kidney
transplantation on plasma electrolytes & albumin
to see whether this contributes to the survival
advantage of kidney transplant recipients over
those on maintenance dialysis.
Methods: We conducted a retrospective cohort
study of 48 patients (M = 29, F = 19; Age = 2484) receiving a kidney transplant at the Royal
Hobart Hospital within the last 10 years.
Biochemical profiles immediately pre- and posttransplantation and over the longer term were
analysed.
Results: Plasma phosphate, magnesium and
potassium increased in direct proportion to degree
of kidney impairment (all p<0.0001), whereas
albumin and calcium decreased (p<0.0001).
Kidney transplantation resulted in an immediate
reduction in phosphate, magnesium (both
p<0.0001) and potassium (p= 0.014). These
reductions were maintained long term (all
p<0.0001). There was no immediate change in
calcium (p=0.34) or albumin (p=0.42), however
over a longer time period both increased
significantly over pre-transplantation levels
(p<0.0001).
References:Foley RN, Parfrey PS, Harnett JD, et
al. Hypoalbuminemia, cardiac morbidity, and
mortality in end-stage renal disease. J Am Soc
Nephrol 1996; 7: 728-736.
Foley RN, Parfrey PS, Sarnak MJ. Clinical
epidemiology of cardiovascular disease in chronic
renal disease. Am J Kideny Dis 1998; 32 (Suppl
3): S112-119.
Hayden MR, Tyagi SC, Kolb L, Sowers JR,
Khanna R: Vascular ossification-calcification in
metabolic syndrome, type 2 diabetes mellitus,
chronic kidney disease, and calciphylaxis- calcific
uremic arteriolopathy: The emerging role of
sodium thiosulfate. Cardiovasc Diabetol 4:4, 2005
Locatelli F, Marcelli D, Conte F et al.
Cardiovascular disease in chronic renal failure: the
challenge continures. Registro Lombardo Dialisi
e Trapianto. Nephrol Dial Transplant 2000; 15
(Suppl 5): 69-80.
Ojo AO, Hanson JA, Wolfe RA, Leichtman AB,
Agodoa LY, Port FK. Long-term survival in renal
transplant recipients with graft function. Kidney
Int 2000; 57: 307–313.
Renal Data System. USRDS 2003 annual data
report: atlas of end-stage renal disease in the
United States. Bethesda: National Institutes of
Health, National Institute of Diabetes and
Conclusion: Kidney impairment resulted in
Digestive and Kidney Diseases, 2003.
disordered calcium, magnesium and phosphate
metabolism, which predisposes to vascular Stenvinkel P, Carrero JJ, Axelsson J, Lindholm B,
ossification and increases CVD risk. Kidney Heimburger O, Massy Z. Emerging biomarkers for
impairment was associated with raised potassium, evaluating cardiovascular risk in the chronic
pro-arrhythmogenic contributing to mortality. kidney disease patient: how do new pieces fit into
Kidney transplantation produced an immediate, the uremic puzzle? Clin J Am Soc Nephrol 2008;
significant improvement in magnesium, phosphate in press.
and potassium levels, which was maintained long
term. Significant improvements in plasma Wolfe RA, Ashby VB, Milford EL et al.
electrolyte homeostasis and albumin Comparison of mortality in all patients on dialysis,
concentrations may contribute to the survival patients on dialysis awaiting transplantation, and
advantage conferred by kidney transplantation recipients of a first cadaveric transplant. N Engl J
Med 1999; 341: 1725–1730.
over maintenance dialysis
154
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No.3.28
Study of Urolithiasis in Gwalior Region
*A.K. Bhargava, **Neelima Singh, **Sanjeev Singh, **Pradeep Sharma, **Dharmveer Sharma,
***Sunil Agarwal and ****Sunita Sharma
*Dept. of Biochemistry, Jhalawar Medical College, Jhalawar; **Dept. of Biochemistry and ***Surgery,
G.R.Medical College, Gwalior; ****Dept. of Biochemistry, Madhav Institute of Science and
Technology, Gwalior
Background: Study of urolithiasis is important
in understanding the pathogenesis and medical
management of calculus disease. Quantitative
analysis of 50 urinary stones (30 kidney, 9 bladder,
11 ureter) collected from different hospitals of
Gwalior region was carried out.
Objective: To study morphological characteristics
of urinary stones. Oxalic acid, uric acid, calcium,
and inorganic phosphate were also estimated.
Results: The incidence of urinary stones was
found as kidney > bladder >ureter The incidence
of kidney stones was higher in age of 30-40 than
ureter and bladder. Oxalic acid was found as a
major component in all the stones analysed.
Calcium content of stones was kidney > ureter >
bladder. Uric acid was seen in stones ureter >
bladder > kidney. Inorganic phosphorus content
of stone was kidney > bladder > ureter.
Hyperoxaluria, hyperuricemia, hyperphosphaturia,
hypercalciuria were found in some cases. The high
incidence of calcium and oxalate urinary stones in
this region may be due to high consumption of
vegetables rich in calcium and oxalate. Other
factors which may be responsible for urolithiasis
are water intake, climatic conditions, dehydration,
metabolic abnormalities, urinary tract infections
and heredity.
Abstract no: 4.1
Cardiovascular Risk Markers in Hypothyroidism
Aparna R.Bitla*, E. Jayanti*, Alok Sachan**, G. Shiva Krishna*, M.M.Suchitra*,
P.V.L.N.Srinivasa Rao* and KVN Raju*
*Department of Biochemistry, **Department of Endocrinology, Sri Venkateswara Institute of Medical
Sciences, Tirupati, A.P. Email ID: [email protected]
Objectives:cardiovascular disease. Overt and sub
clinical hypothyroidism have adverse effect on
serum lipid profile that may predispose to
development of Atherosclerotic disease. However,
the association of the novel risk markers especially
Lp(a) and homocysteine in this group
Hypothyroidism is a common metabolic disorder
and found to be a predictor of of patients is not
well known. Hence, the present study was taken
up to evaluate the traditional risk marker i.e lipid
profile along with the novel markers in patients
with hypothyroidism
Methods:
Twenty five patients with
hypothyroidism diagnosed on the basis of TSH
measurements were included along with twenty
five age and sex matched healthy controls. Lipid
profile and Lp(a) were quantitatively measured on
Beckmann CX9 fully Automated Analyzer using
155
Indian Journal of Clinical Biochemistry Supplement, 2009/24
commercial kits. LDL-C was calculated using
Friedewald formula. Plasma Homocysteine was
measured using a commercial kit by Enzyme
linked immunosorbent assay.
Homocysteine (p<0.05) were observed in the
study group when compared to the control group
Conclusion: The results of the present study
confirm the presence of dyslipidemia in
Results: A significant increase in TGL, total hypothyroid patients. This along with the novel
risk factors like Lp(a) and Homocysteine which
cholesterol, LDL and VLDL (p<0.001) along with
were found to be elevated expose these patients to
a significant decrease in HDL (p<0.05) were increased cardiovascular risk pointing to the need
observed in hypothyroid cases when compared to for institution of appropriate measures early to
controls. Among the novel risk marker, a prevent progression
significant increase in the levels of Lp(a) and
Abstract No: 4.2
Hyperhomocysteinemia, Circulating Folic acid and Cobalamine Levels in Coronary
Syndrome
Yadav AS1, Bhagwat VR2, Mane AY3 and Venugopal NT4
1Dept of Biochemistry, Maharashtra Institute of Medical Sciences & Research, Medical College,
Latur (Maharashtra), 2. Dept of Biochemistry, SBH Govt Medical College, DHULE (Maharashtra), 3.
Dept of Biochemistry, RD Gardi Medical College, Ujjain (MP), 4. Dept of Biochemistry, DY Patil
Medical College, Kolhapur (Maharashtra),
Email: [email protected] , [email protected]
Introduction: Geographical and nutritional
factors are recently shown to have significant role
to play in cardiovascular diseases. The exact
relationship between nutritional and geographic
factors in cardiovascular diseases is not very clear.
This study examines relationship of
hyperhomocysteinemia with circulating levels of
folic acid and cobalamine in patients with
cardiovascular disease from rural area.
were measured by chemiluminescence immunoassay.
Methods: Blood total homocysteine levels were
measured along with folic acid and cobalamine
levels in acute coronary and stable angina patients
from rural areas along with normal healthy
controls from same area. Plasma total
homocysteine was measured by HPLC with
fluorescence detection. Folic acid and cobalamine
Conclusion: There is higher prevalence of
hyperhomocysteinemia in rural Indian patients. It
appears that there is strong association of genetic
factors in development of ischemic heart disease
in Indian patients. Blood homocysteine is very
important biomarker of cardiovascular diseases
which must be evaluated with the other risk factors.
156
Results: Mean total homocysteine levels were
significantly higher by almost three times than the
controls. Folic acid and cobalamine were 3-4 times
higher in the patients compared to the controls.
There was poor correlation between total
homocysteine and the vitamin levels in the
patients.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 4.3
Insulin Resistance and Lipid Profile in Pregnancy Induced Hypertension
Asmathulla.S, Rajagovindan.D and Jakanattane
Department of Biochemistry, Sri Manakula Vinayagar Medical College & Hospital.
Objectives: To study fasting insulin levels and
lipid profile in Pregnancy Induced Hypertension
(PIH) cases and to compare them with normal
pregnant controls. To calculate insulin resistance
in PIH and to compare them with healthy pregnant
controls.
Results: Fasting insulin and HOMA-IR are
significantly increased in PIH cases compared to
controls. Among PIH cases, Preeclampsia showed
significant increase in Insulin and HOMA-IR
levels compared to controls and gestational
hypertension. Total cholesterol, LDL cholesterol
and triacylglycerol are elevated significantly in
PIH. The preeclamptic cases are associated with
significant rise in total cholesterol, LDL
cholesterol, VLDL cholesterol, and triacylglycerol
as compared to controls but these changes are not
significant in gestational hypertension.
Methods: Twenty eight PIH cases and ten normal
healthy pregnant controls are recruited for this
study. Serum Insulin levels are measured by
ELISA method. HOMA-IR is calculated by
(fasting insulin x fasting glucose)/22.5. Total
cholesterol, triglycerides, HDL-cholesterol and
glucose are measured using enzymatic kits using Conclusion: The data from the present study
autoanalyzer. VLDL-cholesterol is calculated by documents Hyperinsulinemia, Insulin Resistance
Friedwald’s formulae.
and Dyslipidemia in PIH patients
Abstract No: 4.4
Hypothyroidism Risk factor for Coronary Heart Disease
B.K.Agrawal*, Bhawna Bhimte*, and V.K.Sharma**
*Department of Medical Biochemistry, Gandhi Medical College, Bhopal, **Department of Medicine,
Gandhi Medical College, Bhopal; Email: [email protected]
Objective: Hypothyroidism has been associated
with abnormal lipid metabolism, causing
dyslipidemia that has been associated with an
increased risk of CHD. Level of increased TSH
values may be associated with extent of lipid
abnormalities.
time of detection & second after 6 weeks of
therapy: TSH: Competitive Solid Phase Enzyme
Immunoassay, Cholesterol: Enzymatic CHODPOD method, HDL: PTA precipitation method,
TG: Friedwald’s enzymatic method, LDL:
Friedwald’s formula, Apolipoprotein B: Ag-Ab
agglutination method, Lipoprotein a: Ag-Ab
Methods :Present study was done in 100 agglutination method.
hypothyroid patients & 3 groups have been
divided on the basis of TSH level Group I: TSH Results: In Group I: Statistically significant
6-20uIU/dl, Group II: TSH 21-40uIU/dl, Group correlation was found between TC (P<0.05), HDL
III: TSH above 40uIU/dl. Following parameters (P<0.001) & TG (P<0.001) whereas LDL values
of same patient were analyzed twice first at the were insignificant similarly Apo B were
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
moderately significant (P<0.01) & Lip a level were
insignificant. Group II: TC, HDL, TG & LDL
values were insignificant, whereas Apo B & Lip a
were moderately (P<0.01) & highly significant
(P<0.001) respectively. Group III: Only the values
of TC were found to be significant (P<0.05),
whereas HDL, LDL, TG Apo B & Lip a levels
were insignificant.
Conclusion: Above results suggests that
hyperlipidemia is associated with extent of
hypothyroidism. Not only higher TSH level, but
even less raise in TSH level is enough to cause
dyslipidemia, increasing the Cardiac risk.
Abstract No: 4.5
Diabetes Accelerates Age-Related Lipid Profile Disturbances
Zafar M.E.* Nehal M.** Teeto S.A. * and Prasad K.R. *
*Bio-Chemistry Department Katihar Medical College, Katihar, Bihar – 854105, India, **Ageing Research
Laboratory, University Department of Zoology, L. N. Mithila University, Darbhanga – 846 004
Objectives:Cardiovascularcomplications (CVC)
are predominant problems both in ageing and
diabetes. The present study focuses on the effect
of human ageing and diabetes , with special
reference to serum level lipid profile during
cardiovascular complications in two age groups
namely, 45 ± 5 years and 65± 5years independent
of obesity, hypertension and nephropathy.
Methods: The parameters include; estimation of
serum total cholesterol, serum triglycerides , HDLC, LDL-C and VLDL-C .
Results:Results show that the change in the levels
of lipid parameters follow a near similar trend in
the two non-diabetic age groups with
cardiovascular complications. Except the HDL-C
decline, total cholesterol, LDL-C, VLDL and
triglycerides increase. In diabetes, however, the
said lipid parameters are not so similarly affected
in the stated age subjects. One interesting
observation is the near similar levels of lipid
parameters found in diabetic 45 ± 5 yr and nondiabetic 65 ± 5 yr age groups with Cardiovascular
complications.
Conclusion:It is, therefore, suggested that diabetes
accelerates age related disturbances in the lipid
profile.
Abstract No: 4.6
Biochemical Study of Emerging Risk Markers in Coronary Heart Disease
H V Singh,1 S Bhandari,2 N Singh,3 S Singh,3 ..and A Raizada 2
1
Department of Pathology, Hindu Rao Hospital, Delhi-110007, 2Department of Biochemistry &
Cardiology, Escorts Heart Institute& Research Centre, New Delhi-110025, 3Department of
Biochemistry, G.R.Medical College, Gwalior-47400
Introduction: To provide the best treatment for
coronary heart disease (CHD) patients, one must
go beyond LDL cholesterol to detect factors
contributing to CHD risk or existing CHD. These
158
emerging risk factors appear to identify individuals
at increased CHD risk and the assessment of these
can modulate clinical judgment when making
therapeutic decisions. This study focus on five
Indian Journal of Clinical Biochemistry Supplement, 2009/24
markers lipoprotein (a) (Lp(a)), high sensitive c- or reduced significantly (p<0.001) and it is
reactive protein (hs-CRP), Total antioxidant status confirmed by the elevated lipid peroxidation
product MDA in both groups.
(TAS), homocysteine and Fibrinogen.
Methods: Study was carried out by taking 396
subjects, out of which 127 control cases were
selected by screening with lipid profile, treadmill
test (TMT) and fasting blood sugar, to ensure that
they are not suffering from hyperlipidemias,
dyslipidemia or diabetes. 269 angiographically
proven CAD cases were selected for the present
work. Lp(a), hs-CRP, TAS was estimated using
Hitachi 912 analyser. The levels of Homocysteine
were estimated by EIA method using Bio-Rad kit
in Bio-Rad CODA analyzer. The levels of
fibrinogen were estimated by Clauss method in
Sysmax Autoanalyzer.
Results: Recent markers Lp (a), hs-CRP,
homocysteine and fibrinogen levels were
significantly increased in CAD cases. TAS was
significantly decreased in the CAD group. The
homocysteine level was significantly increased
(p<0.001) in the present study. Oxidative indices
like total antioxidant capacity was found decrease
Conclusions: The statistical analysis of the study
shows that these markers are more closely
associated with atherosclerosis. Recent cardiac
markers i.e. homocysteine and Lp (a) showed no
significant correlation in our study with other
parameters therefore they may be considered as
independent markers. Lp (a) is closely associated
with LDL and low values of HDL-C so it could
also be considered as independent marker for CAD
assessment. The inflammatory markers hs-CRP
and fibrinogen emerged as a marker of choice to
diagnose atherosclerosis. Many previous studies
also showed that persistent hyperglycemia can
cause oxidative stress followed by release of
inflammatory markers and then formation of
atheroma in vessels. The screening with the
emerging risk markers is helpful in risk assessment
of coronary Heart disease. This additional
diagnostic information can assist in the prevention
or early diagnosis and treatment of atherosclerotic
cardiovascular disease.
Abstract No: 4.7
Anti-oxidant Potential (AOP) of LDL in Post Menopausal Women Suffering from
Type 2 Diabetes Mellitus.
Nivedita Singh, Neelima Singh, Sanjeev Singh and Vishal Bhargava
Department of Biochemistry, G.R. Medical College, Gwalior
Objectives: Menopause occurs as the age
advances in life of women (40-50 years). Post
menopausal phase is associated with absence of
estrogen known to be cardio protective and potent
antioxidant hormone. A strong association of
absence of estrogen and cardiovascular
complication in post menopausal diabetic female
has been reported.
years)and 50 post menopausal diabetic female
subjects.
Results: It is concluded from study that in these
subjects
besides
hyperglycemia,
hypertryglyceridemia and hyperchole-sterolemia
also exists. LDL and VLDL were increased
(P<0.001) with decrease of HDL cholesterol
(P<0.001). Sensitivity for oxidation of LDL in
Methods: The present study has been carried out these subjects were found increased and therefore
in 50 age matched healthy female (40-50 antioxidant potential (AOP) of LDL was decreased
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 4.8
Increased Levels of Inflammatory Markers, Sialic Acid and Cardiovascular Risk
Factors in Type 2 Diabetes Mellitus.
Dr S.Rajesh1, Dr S.Sethupathy2 and Dr S.M.Rajendran3
Division of Biochemstry, Chettinad Hospital and Research Institute, 2. Division of Biochemistry,
Raja Muthiah Medical College, Annamalai University, 3. Division of Medicine, Raja Muthiah Medical
College, Annamalai University
Objective:Type II DM patients generally carry a
number of risk factors for CVD.
Microalbuminuria, Serum sialic acid (TSA) and
elevated levels of inflammatory markers,
particularly hs C-reactive protein have been shown
to be cardiovascular risk factors. There are no
satisfactory data on circulating concentrations of
inflammatory cytokines and their potential
relationship with traditional and nontraditional
cardiovascular risk factors in a diabetic population.
The aim of the present study was to examine the
relation of serum cytokines ,microalbumiuria and
serum sialic acid concentrations, to cardiovascular
risk factors in type2 diabetic patients.
necrosis factorα , Interleukin-6, C-reactive protein,
Lipid profile, Apo-A1 and Apo-B were estimated.
Results: Statistical analysis was done using Systat
ver. 12.0 software. RESULTS –Highly significant
association was found between Microalbuminuria
and Crp(0.001),Sialic acid (0.001).TNFα and Apo
B (p=0.02),Total cholesterol(p=.03), IL-6 and ApoB (P=0.01),Apo-A(P=0.08), Sialic acid and ApoB(P=0.017),Totalcholesterol(p=0.00), Apo
A(p=0.000) , TGL(p=.01).CRP and Apo-B
(p=.02), Apo-A(p=.001).
Conclusion: The present study provides evidence
of a significant increase in inflammatory markers,
Methods: we enrolled 80 type 2 diabetic patients, sialic acid and cardiovascular risk factors in type
without any major systemic illness. 2 diabetics with increased urinary albumin
Microalbuminuria, Serum sialic acid, Tumor excretion.
Abstract No: 4.9
Influence of Atherosclerosis and Exercise on Arterial Lipoprotein
Lipase Activity in Pigs
Shakti Aggarwal, Theodore W. Zderic, Perminder Gulani and Marc T. Hamilton,
University of Missouri-Columbia, USA.
Objective: Lipoprotein lipase (LPL) has
repeatedly been identified as one of the major
susceptibility genes for human coronary artery
disease. However, the functional enzyme activity
has heretofore never been quantified in arteries
with respect to either vascular disease or exercise
training. We have overcome prior experimental
limitations by utilizing a porcine model of
atherosclerosis, where the endothelium from large
160
arterial samples could be obtained in conjunction
with modifications in the LPL assay to improve
accuracy. The primary purpose was to determine
the effects of exercise training on arterial LPL
activity in a porcine model of atherosclerosis.
Methods: Heparin releasable LPL (HR-LPL)
activity was measured in approximately 5.2 cm2
of the thoracic aorta, skeletal muscle and adipose
Indian Journal of Clinical Biochemistry Supplement, 2009/24
tissue. In keeping with the purpose, a pig strain
with familial hypercholesterolemia (FH) was run
trained for ~5 months and compared to controls
fed an identical diet (N=13 run trained and N=12
untrained). As a basis of comparison to generally
healthy pigs, LPL was measured in another strain
of pigs with substantially lower plasma cholesterol
(Yucutan).
19±3 mU/mg total protein; p<0.05). This two-fold
training effect for artery HR-LPL was evident in
both males and females. In contrast to this, neither
skeletal muscle, nor adipose HR-LPL activity was
altered by the exercise training. Paradoxically,
arterial HR-LPL activity was 13.7 fold greater in
FH pigs (21.3±4.6 mU/mg), compared to the
Yucatan pigs (1.6±0.2 mU/mg).
Results: There was about twice as much arterial Conclusion:: Exercise run training increased
HR-LPL activity in FH pigs after the exercise arterial HR-LPL activity in a porcine model of
training compared to sedentary controls (40±4 vs. lipoprotein-induced atherosclerosis.
Abstract No: 4.10
Study of Apolipoprotein A-1, B and Lipid Profile in Premenopausal and
Postmenopausal Women
Dr. Swapnali* and Dr. D.S. Jayaprakash Murthy.
Department of Biochemistry, J.J.M. Medical College, Davangere-577004, Karnataka.
Email: [email protected] or [email protected]
Background: Menopause is an estrogen deficient state. Natural menopause confers a threefold increase in coronary artery disease (CAD)
risk. Currently postmenopausal women account
for more than 30% of the female population at
risk for CAD in India.
Results: TC, TG, very low density lipoprotein
(VLDL), low density lipoprotein (LDL), Apo B,
TC/HDL and Apo B/Apo A-I were increased,
whereas HDL and Apo A-I were decreased in
postmenopausal women when compared to premenopausal women and were statistically
Objective: So this study was conducted to as- significant (p < 0.001).
sess the
relationship between serum Conclusion: Apo A-I and HDL cholesterol are
apolipoprotein (Apo) A-I, Apo B and lipid pro- antiatherogenic whereas Apo B and LDL cholesfile in healthy premenopausal and postmeno- terol are atherogenic. The cholesterol content of
pausal women.
HDL and LDL as an indicator for risk of CAD
Methods: About 123 healthy subjects were studied (62 premenopausal and 61 postmenopausal
women). Total cholesterol (TC), triglycerides
(TG) and high density lipoprotein (HDL) were
estimated by enzymatic method and Apo A-I
and
Apo
B
were
estimated
by
immunoturbidimetric method by semiautoanalyzer.
may be misleading because the cholesterol content varies with a variety of physiological and
pathological conditions but not their protein
content. Hence estimation of Apo A-I and Apo
B, the protein part of HDL and LDL respectively
serves as a more reliable tool in predicting the
risk of CAD in postmenopausal women
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 4.11
Significance of Plasma Total Homocysteine Levels in Type II Diabetes
Mellitus Ppatients
Anbazhagan M and Ben S. Ashok
Dept. of Biochemistry, Sri Ramachandra University, Porur, Chennai.
Background: Diabetes mellitus is a common
disease with many complications. CVD is the
major cause of death in Type II diabetes mellitus.
In recent years several studies have demonstrated
that elevated homocysteine is a risk factor for
atherosclerosis. Elevated homocysteine levels
increase the risk of every complication associated
with type II diabetes. This study was aimed to
determine the relationship between blood glucose,
Total cholesterol and fasting total homocysteine
(tHcy) levels in patients with Type II diabetes with
no renal complications.
levels were measured by GOD-POD method and
Total cholesterol were measured by CHOD using
Hitachi 902 analyzer in 110 diabetics patients and
60 non diabetics.
Results: Plasma tHcy levels were found to be
significantly high in diabetics than non diabetics
(p< 0.01). Total cholesterol levels were also found
to be significantly high in diabetics than non
diabetics (p<0.01).
Conclusion: As hyperhomocysteinemia also
reflect endothelial injury, the present observation
Methods: Plasma tHcy was measured by support the hypothesis that hyperchemiluminescence assay using siemens Advia homocysteinemia appears as an risk factor for
centaur. Fasting and post prandial blood glucose CVD in type II diabetes patients.
Abstract No: 4.12
Apolipoprotein A1 Gene Polymorphism (G-75A and C+83T) in Patients of
Myocardial Infarction- a Pilot Study in North Indian Population.
Rajni Dawar1 *, Anil Gurtoo2 and Ritu Singh1
1
Department of Biochemistry, Lady Hardinge Medical College & Associated S.S.K Hospital. New
Delhi-110001. India, 2Department of Medicine, Lady Hardinge Medical College & Associated S.S.K
Hospital. New Delhi 110001. India.
Objective: To study whether genetic
polymorphism in ApoA1 gene (G-75A and
C+83T) could be playing a role in occurrence of
Myocardial Infarction.
Methods: Study group consisted of 100 subjects
(50 diagnosed MI patients, 50 healthy subjects).
S. Apolipoprotein A1 and S. Apolipoprotein B
were estimated by immunoturbidometric assay on
SYNCHRON CX9 (BECKMAN). Extracted
162
DNA from blood sample was amplified by PCR,
which was digested overnight with MspI
restriction enzyme. Digested products obtained
were run on 8% Polyacrylamide gel and
Restriction fragment length polymorphism was
studied by gel documentation system.
Results: S. ApoA1 levels were significantly higher
in control group compared to study group (100.80
±7.06mg/dl and 72.56±9.86mg/dl respectively;
Indian Journal of Clinical Biochemistry Supplement, 2009/24
p<0.0001) and S. Apo B levels were significantly
higher in study group compared to control group
(97.45 ± 9.04mg/dl and 72.12 ± 11.32mg/dl
respectively; p<0.0001). The frequency of the G
allele at -75bp site was higher in the study group
(79%) compared to controls (58%).Genotypic
distribution in study group was [GG
(58%),GA(42%)] compared to controls
[GG(16%),GA(84%)] with p<0.0001. The
frequency of the T allele at +83bp site was higher
in the study group(56%) compared to
controls(32%).Genotypic distribution in study
group [CC(24%),CT(40%),TT(36%)] was
different as compared to controls
[CC(36%),CT64%)] with p<0.0001.
Conclusion: In Apolipoprotein A1 gene, G at 75bp upstream from start of transcription and T at
+83bp site in the first intron may be susceptibility
alleles for myocardial infarction in Indian
Population. However, ours being a pilot study,
more studies with larger sample size are needed to
confirm genotypic risk associated with G and –
(T) allele.
Abstract No: 4.13
Role of Pro-inflammatory Cytokines, ApoB and Small Dense LDL in Women with
Coronary Artery Disease
Sunita1, S.B Sharma1, D.Puri1, R.L.Tripathi 1 and S.Dwivedi2
Department of Biochemistry1 and Medicine2, University college of Medical Sciences, Delhi, India.
Objective: Inflammation plays important role in
initiation and progression of atherosclerosis.
Therefore assessment of Pro- inflammatory
markers such as hs-CRP,IL-6,ApoB and small
dense LDL help in the prediction of risk and can
aid in treatment plan in female patients of CAD
who present with atypical symptoms so that
mortality associated with CAD can be decreased.
highly significant (p<0.001) in MI & UA as
compared to controls.LDL-C was also significantly
increased (P<0.05) in MI as compared to UA.TG
and HDL-C were also increased but not at the
significant level(p>0.05).ApoB ,hs-CRP & IL-6
were highly significant(p<0.001) in UA & MI as
compared to controls.Small dense was highly
significant(p<0.001) in CAD as compared to
controls.96.7% of UA & 83.3% of MI showed
Methods: Present study comprises 90 female
presence of small dense LDL.
subjects of age 40-65 years which included 30
healthy controls, CAD patients into 30 cases of Conclusions: Levels of TC, LDL-C were high in
unstable angina (UA) & 30 cases of myocardial patients of UA & MI. ApoB, hs-CRP & IL-6 were
infarction (MI).Fasting blood samples analyzed high in patients of CAD as compared to controls.
for lipid profile, ApoB using standard methods. These high levels reflect severity of CAD & thus
hs -CRP and IL-6 were analysed by ELISA. Small help in risk stratification .Small dense LDL was
dense LDL was calculated by ratio of LDL-C/ highly increased in UA as compared to MI which
ApoB.
suggest that small dense LDL are precursor of
atherogenesis.
Results: Total cholesterol (TC) & LDL-C were
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 4.14
Dyslipidemia and Anti-oxidant Nutrient in Pre-eclampsia
Dr.M.G.Dhabe*, Dr. (Mrs.)S.C.Choudhary** and Dr.M.R.Mogarekar*
*SRTR medical College,Ambajogai,Dist Beed, Maharashtra.**B.J.Medical College,Pune.
Objective: Preeclampsia is the main cause of
maternal and perinatal mortality and contributes
8% of maternal deaths in India. In women with
preeclampsia there is dyslipidemia and decreased
antioxidant activity. The present study was
undertaken to evaluate the lipid (cholesterol& TG)
levels and serum ascorbic acid level in
preeclampsia.
Methods: For the present study, we have selected
40 normotensive pregnant women of age group
20-35 years comprising Group I and 40 preeclamptic women of same age group comprising
Group II. Serum samples were analysed for serum
total cholesterol, triglycerides and serum ascorbic
acid levels.
Results: A significant increase in serum total
cholesterol and serum triglyceride levels were
found in Group II as compared to Group I while
serum ascorbic acid levels were decreased
significantly in Group II as compared to Group I.
Conclusion: In preeclampsia there is
dyslipidemia. The hypertriglyceridemia may lead
to increased endothelial triglyceride accumulation
that in turn may result in endothelial dysfunction
probably by promoting oxidative stress in arterial
wall. The antoxidant nutrient like ascorbic acid
may be utilised to greater extent to counteract free
radical mediated cell disturbances resulting in
reduction in antioxidant nutrient level in serum.
Abstract No: 4.15
Post Coronary Stenting Decrease in Atherogenic Risk Factors
Kavitha S1, Sridhar M G1, Satheesh S2 and Balachander J2
Department of 1Biochemistry and 2Cardiology, JIPMER, Puducherry
Objective: To study the effect of coronary stenting estimated before and three days after coronary
on atherogenic risk factors in patients with stent surgery using paired-t-test.
coronary heart disease (CAD).
Results: A significant reduction was observed in
Methods: A total of 24 acute coronary syndrome total cholesterol (157.6±32 vs. 140.4 ±29.9,
(ACS) patients who underwent coronary stenting p=0.01), triglyceride (195.5±85 vs. 147±59,
were enrolled in the study. The study group p=0.001), total cholesterol/HDL (3.9±0.7 vs.
included patients with acute ST-elevation 3.6±0.7, p=0.05) and triglyceride/HDL (5.1±2.5
myocardial infarction (STEMI) and non–ST vs. 3.9±1.7, p=0.004) levels after coronary
elevation ACS, (NSTEACS). Lipid profile stenting. There was no significant difference in
parameters and atherogenic indices like total HDL–Cholesterol, LDL- Cholesterol and HDL/
cholesterol/HDL, triglyceride/HDL were LDL after three days of coronary stenting.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Conclusion: The present study shows that a stenting. However factors causing this decrease
significant decrease in atherogenic risk factors is need further evaluation.
found in CAD patients following coronary
Abstract No: 4.16
Serum Uric Acid in Acute Myocardial Infarction
Gargi Sen and Virupaksha H. S.
Department of Biochemistry. J.S.S. Medical College and Hospital, S.S.Nagar.Mysore-15, Karnataka.
Background: High uric acid is considered a
negative prognostic marker in heart failure. Close
association exists between uric acid and Killip
classification of acute myocardial infarction
patients.
serum uric acid was high in M.I patients. The
association of uric acid with Killip class at day
0,3,7 was analyzed and the classification of uric
acid was carried out as normal < 7 mg/dl and
abnormal >7 mg/dl. It was observed that at day 0,
3 and 7 there was significant association between
Objective: To estimate serum uric acid in patients Killip class and uric acid levels. No statistically
with M I and correlate it with Killip class, FBS, significant association was observed between uric
HbA1C, Blood Pressure and obesity.
acid levels and age, sex, hypertension, diabetes
Methods: 30 patients with myocardial infarction mellitus and obesity individually.
and 30 controls were studied. Serum uric acid was Conclusion: Uric acid levels were higher in
measured on day 0,3,7 of M I. FBS, HbA1C, patients of myocardial infarction and correlated
Blood Pressure and Body Mass Index was noted. with Killip class independent of other cardiac
Results: Statistically significant higher levels of biomarkers. Combination of Killip class and serum
uric acid was found in M.I patients on day 0,3,7 uric acid levels after MI, could act as a good
as compared to controls ,thereby indicating that prognostic indicator in these patients.
Abstract No: 4.17
Apolipoprotein B, Total Cholesterol, HDL-C, Non HDL-C, LDL-C and Triglycerides
as Risk Factors of Atherosclerotic Vascular Disease
Jitty George, Dr.Andrews M.A, Dr.Cibu Mathew, Dr.Geetha Damodaran K;, Dr.Gilsa E
1.Sixth-semester MBBSstudent, 2. Professor of Medicine, 3. Assistant Professor of Cardiology, 4.
Associate Professor of Biochemistry, 5. Senior Lecturer of Biochemistry;
Email ID:[email protected]
Objective: To find out relative significance of
serum levels of ApolipoproteinB versus Total
Cholesterol, HDL cholesterol, Non HDL
cholesterol, LDL cholesterol and Triglycerides in
atherosclerotic vascular disease.
Methods: Design: Observational case control
study. Setting: Medical College Chest Hospital,
Thrissur. We measured fasting serum
Apolipoprotein B and fasting lipid profile.
Inclusion criteria: Patients of any age with
atherosclerotic
vascular
disease
Controls:Clinically normal persons Exclusion
165
β
Indian Journal of Clinical Biochemistry Supplement, 2009/24
criteria: Patients already on lipid lowering drugs
Controls: Those with diabetes and hypertension
and those on lipid lowering drugs Apolipoprotein
B was measured by immunoturbidimetry; total
cholesterol by enzymatic method; HDL by
phosphotungstic precipitation method; LDL by
indirect method; Triglyceride by enzymatic
method. Non-HDL was calculated as TC minus
HDL-C. Semi auto analyzer was used for all
measurements. Fasting blood sample was used
for all assys. Data analysis: ATPIII guidelines
were used to select cut off values:Total
cholesterol>200mg%, HDL- C<40mg%, LDLC>100mg%, Non HDL-C >130mg%
,TG>150mg%.Cut
off
for
apolipoproteinB(105mg%) adopted from a
previous study done by Sakurabayashi.
Results: The values of TC(p=0.484),NonHDL–
C(146±102 vs 130?80;p= 0.386), LDL-C(121±96
vs 108 ± 78;p=0.895) and TG(129 ± 106 vs
107 ± 100;p= 0.746) are found statistically
insignificant.Only
HDLC(5 ± 32
vs
63 ± 26;p=0.025) and apolipoproteinB(116 ±
46vs95 ± 28;p=0.001)are found statistically
significant.
Conclusion: ApolipoproteinB value of ≥ 105mg%
(P<0.001) is found to be most significantly
associated with atherosclerotic vascular
disease.Hence measurement of ApolipoproteinB
levels is highly recommendable in the risk
assessment of atherosclerotic vascular disease for
early recognition and prevention.Moreover, it can
be performed on nonfasting blood sample also.
Abstract No: 4.18
Accuracy of Retinal Changes in Predicting Microalbuminuria in Obese and Nonobese Hypertensive Patients
Arul Senghor*, Ebenezer William* and Jothimalar**
*SRM medical college Potheri, **SRMC Porur
Objective: Hypertension and obesity is becoming
a common health problem worldwide. It is linked
with vascular inflammation, lipotoxicity and
oxidative stress that results in vascular end organ
damage. Aim of the study is to measure the
inflammatory markers of vascular endothelium,
namely hs-CRP and urinary microalbumin in
obese and non-obese hypertensives, that predicts
the future cardiovascular events.
Methods: The study was conducted among 120
subjects who were non-smokers and non-alcoholic
of age 40 – 60 yrs with hypertension. Patients were
divided into three stages of hypertension according
to JNC-6. Fasting blood samples were collected
to estimate glucose, lipid profile, blood urea
nitrogen, creatinine, hs-CRP, TC, DC. Overnight
spot urinary sample was collected to measure
166
urinary microalbumin. Fundus changes were
observed to assess the vascular endothelial
damage.
Results: The mean of hs-CRP and microalbumin
was significantly high in obese than non-obese
hypertensive group (p= 0.000). There was a strong
correlation between hypertensive retinal changes
and microalbuminuria (P < 0.0001 ). Tests of
accuracy for retinopathy as a predictor of
microalbuminuria showed a sensitivity of 72% and
specificity of 81%.
Conclusion: hs-CRP and urinary microalbumin
are early markers of endothelial dysfunction which
can predict cardiovascular risk in hypertensives.
Retinal changes have moderate accuracy in
predicting microalbuminuria
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 4.19
Circulating Levels of Cell Adhesion Molecules in Hypertension
Kavita K. Shalia, Manoj R. Mashru, Jagdish B. Vasvani, Rajashree A. Mokal. Shilpa M.
Mithbawkar and Priti K. Thakur
Sir H. N. Medical Research Society, Sir H. N. Hospital and Research Centre, Mumbai.
Objective: Hypertension causes complications
such as coronary atherosclerosis and thrombosis
wherein inflammatory factors play significant role.
In the present study inflammatory molecules such
as cell adhesion molecules (CAMs); endothelial
(E)-selectin, platelet (P)–selectin, intercellular
CAM-1 (ICAM-1), vascular CAM-1 (VCAM-1)
and platelet endothelial CAM-1 (PECAM-1) were
analysed in subjects newly diagnosed with
hypertension with no secondary cause against
normotensive healthy individuals.
Methods: In each group 57 subjects were recruited
and soluble (s) levels of CAMs were analysed by
ELISA. Medians were compared by Mann
Whitney U test and correlation was analysed by
Spearman Correlation.
Results: As compared to controls median of sEselectin, sP-selectin and sICAM-1 were
significantly elevated by 49.2%, (P=0.001), 54.3%
(P=0.001), 18.9% (P=0.012) respectively in
hypertensive subjects. Significant negative
correlation was observed of sP-selectin (spearman
rank correlation coefficient (rs) =−0.345, p=0.027)
and sPECAM-1 (rs =−0.446, p=0.003) with age in
hypertension group.
Conclusion: Hypertension may increase
expression of certain CAMs while younger
hypertensives in addition are also at increased risk
of atherothrombosis.
Abstract No.4.20
Serum Paraoxanase Activity and its relationship with Atherogenic Index of Plasma
(AIP) in Hyperlipidemic Patients
Kavya R, Phani M.N, Supriya.M, Jeevan K.Shetty and Mungli Prakash
Department of Biochemistry, Kasturba Medical College, Manipal -576104;
E-mail id: [email protected]
Objective: Paraoxonase (PON 1) is a high density
lipoprotein associated enzyme, is proposed to have
an antiatherogenic effect by preventing LDL
oxidation. Atherogenic index of plasma (AIP) is
the index used to predict the risk of atherosclerosis.
Aim of our present study was to investigate the
relationship between AIP and PON 1 activity in
newly diagnosed hyper lipidemic patients.
hyperlipidemic patients who came for routine
check up without any systemic disease and 50
healthy controls. Lipid profile was analyzed by auto
analyzer and PON 1 activity were determined
spectrophotometrically using substrate
paraoxan.AIP was calculated using formula log
[TG/HDL-C].
Results: There was significant increase in TC, TG,
Methods: The serum lipid profile, PON 1 and AIP LDL-C, AIP (p<0.001) and significant decrease in
were estimated in 50 newly diagnosed HDL and PON 1 (p<0.001) in cases compared to
167
Indian Journal of Clinical Biochemistry Supplement, 2009/24
controls. There was no significant correlation
between PON 1 & AIP.
Conclusion: According to our study,
hyperlipidemic patients has got decrease in PON
1 activity, increase in AIP without having
significant correlation between them. This suggests
decrease in PON 1 activity and increase in AIP is
the independent risk factors for development of
atherosclerosis
Abstract No: 4.21
Trends in Blood Pressure with Increasing Serum Homocysteine Levels
Kumar. Animesh1, Gupta. P. R2and Ali. Z3
Biochemistry Department, 1Himalayan Institute of Medical Sciences, Dehradun, 2 Cardiology Department
and 3 Biochemistry Department, IMS B.H.U. Varanasi. Email: [email protected]
Introduction: It has been predicted that by 2020
there would be a 111% increase in cardiovascular
deaths in India due to hypertension resulting in
cardiovascular diseases (CVD). Mild elevations
in serum homocysteine may contribute to
elevations in blood pressure which may be one of
the important causes for CVD. Controversy
remains as to whether the relation between
homocysteine and CVD is causal or not? Our study
comprises the relationship of homocysteine with
blood pressure.
Methods: Our study consists of 40 subjects
diagnosed as hypertensive for the first time and
20 controls with normal Blood pressure taken
randomly from cardiology OPD of our hospital.
Most of the patients of both sexes were from
Eastern Uttar Pradesh (Varanasi) and from Bihar.
They were in the range of 25 to 60 years of age.
Levels of Homocysteine were measured in serum
by ELISA technique and Blood pressure along with
clinical history was observed separately for all
subjects.
Results: It was observed that Homocysteine was
significantly elevated in hypertensive patients as
compared to controls with p<0.001. It also bears a
high degree of correlation with systolic blood
pressure. It was also observed that the sex along
with age and life style plays a very important role
for our study.
Conclusion: This study shows that homocysteine
is significantly elevated in patients of hypertension
and concludes that in every CVD patients
homocysteine plays a very important role.
Abstract No: 4.22
Coronary Heart Diseases and Serum Triglycerides
K Ram achandran, Divya K.V., Ajeena and Sheela
Email ID: [email protected]
Objectives: There are many etiological factors
responsible for the development of coronary heart
diseases (CHD) and there are many cardiac
markers for the assessment of CHD. The present
study was undertaken to assess whether the various
168
cardiac markers pertain or indicate the etiology of
CHD. Markers studied in this study are Total
cholesterol, HDL cholesterol, LDL cholesterol,
Triglycerides, CK-MB, AST and Troponin I.
Etiological factors for CHD in the present study
Indian Journal of Clinical Biochemistry Supplement, 2009/24
are 1. Long standing Diabetes Mellitus (DM), 2.
Hypothyroidism, 3. Nephrotic syndrome, 4. Liver
cirrhosis. Other estimations done in this study are
blood glucose,serum ALP, blood urea and serum
creatinine.
fasting blood glucose estimation, lipid profile,
enzyme studies, urea and creatinine.
Results: 1. Group 1 and Group 3 - high fasting
blood glucose (value more than 180mg%), 2.
Group 1 and Group 2 - high total cholesterol, high
LDL cholesterol, high triglycerides, high VLDL.
3. Group 3 and Group 4 - normal cholesterol 4.
HDL cholesterol was found satisfactory in all the
groups 5. AST and ALP upper normal limit in
group 2 only. 6. Blood urea and serum creatinine normal in all groups 7. Serum creatinine - normal
in all groups.
Methods: Total cholesterol by using
cholesterolesterase - Cholesterol oxidase –
Peroxidase, Triglycerides - GPO-PAP end point
assay, HDL cholesterol - precipitation method
using phospho tungstate and magnesium acetate
reagent, LDL cholesterol - calculated by
Friedwald’s formula, CK-MB - based on
immunoinhibition method using G6PD, AST- by
Conclusion: 1. The present study established a
coupled enzyme using malate dehydrogenase,
close relationship between DM and CHD, 2. Total
Troponin I - by card test
cholesterol is elevated in these two conditions and
Blood glucose - by GOD-POD method, ALP- by is responsible for CHD, 3. HDL cholesterol was
PNPP method, Blood urea - by GLDH method, found satisfactory in DM and CHD which is a
Serum creatinine - Jaffe’s method. 60 patients significant finding compared to other study -that
admitted in Co-operative medical college, Kochi is HDL cholesterol may not truly represent
coming under the age group 50 to 82 years were atherosclerosis in physically active people, 4.
selected. They were grouped into Group 1 - DM Triglycerides and VLDL represent the occurrence
+ CHD, Group 2 - CHD only, Group 3 - DM of CHD and atherosclerosis, 5. There is no
without CHD with 20 patients in each group. involvement of hepatic an renal dysfunction in the
Group 4 - Normal (20 people). Blood sample was occurrence of CHD with DM.
collected from all persons from all groups for
Abstract No: 5.1
Investigation Profile Correlated with Adverse Maternal and Perinatal Outcome in
Pregnancy Induced Hypertension (PIH)
Ms.Liggy Andrews, Dr.N.Haridas* and Dr. Smruti Vaishnav**
1.Dept of Biochemistry, ** Dept of Obstetrics & Gynecology. Ms. Liggy Andrews, Department of
Biochemistry. C.U.Shah medical college. Surendranagar. Email Id: [email protected]
Background: PIH is still a major cause of of biochemical profile of adverse pregnancy
Obstetrical and Perinatal morbidity and mortality. outcome in PIH
From the stand- point of prevention, PIH has
Method: Study was conducted in Biochemistry,
remained a constant challenge to the obstetrician.
Obstetrics & Gynecology Department at
Objective: To evaluate & correlate the significance S.K.Hospital, Karamsad, Gujarat-January 2006 to
169
Indian Journal of Clinical Biochemistry Supplement, 2009/24
March 2008.Total 328 PIH &100 normal pregnant AST* & APTT* - significantly associated with
women were studied. All biochemical tests maternal mortality. While urea*, creatinine*,
APTT*, uric acid*, calcium*, LDH*, ALT & AST
analyzed on Xl-300.
- significant with Perinatal mortality. Uric acid
Results:Total no. of deliveries — 2237. Out of
>6.0mg/dl in 9 maternal and 66 perinatal deaths
which 328 had PIH (prevalence 14.7%).Out of
while LDH >600IU/l in 50 perinatal deaths
which mild PIH — 117(5.2%), severe PIH
136(6.0%), Eclampsia 67(2.9%) and chronic HT Conclusion: Standard antenatal follow up should
8(0.35%). Complications were hematological be carried out for the early detection and
(22.5%) — DIC(3.0%), HELLP syndrome (3.9%) prevention of adverse consequence related to PIH.
and thrombocytopenia (15.5%) was the most All biochemical markers should be carried out in
common maternal complication associated with each PIH patient to help predict and to deal with
mortality and morbidity. 9(2.7%) maternal deaths the adverse pregnancy outcome and
and 86(26.2%) Perinatal deaths (SB 56 & 29 complications.*(P<0.000)
NND) occurred in this study. Biochemical
parameters were analysed. Uric acid*, ALT*,
Abstract No: 5.2
Status of Lipid Profile in Patients of Acute Myocardial Infarction
K.Suchitra, Bari Siddiqui M A and U Satyanarayana
Dept of Biochemistry, Siddhartha Medical College, Dr NTR University of Health Sciences, Vijayawada,
Andhra Pradesh 520008. [email protected]
Introduction: Alterations in the lipid profiles have
been reported in patients of acute myocardial
infarction (AMI). These reports however are
controversial- some claim reduction while others
report increase in different parameters of lipid
profile. The objective of the study was to evaluate
the changes that occur in lipid profile in AMI,
including the ratios of total cholesterol / HDL
cholesterol, and LDL cholesterol / HDL
cholesterol.
Methods: This study was conducted in 25 patients
of AMI admitted at Government General Hospital,
Vijayawada. Fasting(14 hr) blood samples were
collected at 24 hours, 48 hours and 5 days predischarge, and serum was analyzed for TG, total
cholesterol, HDL cholesterol, VLDL and LDL
cholesterol were calculated using Friedwald
formula.
170
Results: There was no significant change in the
serum total cholesterol at 24 hours, 48 hours and
5 days pre- discharge. HDL cholesterol marginally
fell at 48 hours; VLDL showed slight increase at
48 hours and 5th day pre- discharge. Changes in
LDL cholesterol were negligible. Serum TG
showed an increasing trend after MI at 48 hours
and 5th day pre- discharge. An elevation in the
ratios of total cholesterol / HDL cholesterol was
observed at 48 hours and 5th day pre- discharge.
However, LDL / HDL ratio remained almost the
same.
Conclusion: It is concluded that although there
are variations (24 hours, 48hours and 5th day predischarge) in the lipid profile in the patients of
AMI, the ideal period for the estimation of lipid
profile appears to be within 24 hours of the acute
episode.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 5.3
A Study of Age Related Changes in the Serum Lipid Levels in Healthy Adults of
Mangalore City
*Dr.Malathi.M, and Ms.Sangita Kamath
Professor, Dept of Biochemistry, Fr Muller medical college,Mangalore. E mail :
[email protected]
Background: Coronary artery disease (CAD) is
the most common type of heart disease..
Hyperlipidemia is considered as one of the risk
factors in the development of coronary artery
disease .(CAD) . The National Cholesterol
education program (NCEP) has suggested normal
reference ranges for lipid profile. However various
epidemiological studies done in different parts of
India show different cut off levels suggesting that
the lipid levels could be influenced by various
geographic factors .These studies point out the
need to survey the population region wise and to
establish normal reference ranges in them.
healthy controls of age groups between 21-75 yrs
was assayed in the laboratory using autoanalyser
by the recommended methods .The results were
then categorized age wise under four groups .
Stastical analysis was done by student t test and
ANOVA (analysis of variance) methods.
Objectives: To assess the average lipid levels in
the healthy adults of Mangalore city and to set up
age and sex matched reference ranges in the
population.
Conclusion: Screening for dyslipidemia in all
adults above 20 years and Health education
regarding modification of life style and dietary
habits would be useful to control hyperlipidemia.
Results: The overall lipid level was found to be
on the higher side of the normal reference level in
the study population. In males lipid levels were
found to be higher in 36-50 yr age group and in
females in the postmenopausal group who were
beyond 50 yrsof age.
Methods: Total cholesterol, LDL cholesterol,, Acknowledgment: This study was done as ICMR
HDL cholesterol and Triglyceride levels of 200 STS project in 2005
Abstract No: 5.4
Systemic Failure of Interferon-á synthesis, a Potent Inhibitor of Platelet Aggregation
and a Thrombolytic Agent, and its Role in the Development of Acute Myocardial
Infarction.
Mau Bhattacharyya, and Asru K. Sinha*
Sinha Institute of Medical Scince and Technology, 288 Kendua Main Road, Baishnabghata, Garia,
Kolkata-700084, E mail- [email protected]
Objectives: We have reported before that the
increase of nitric oxide synthesis in leucocytes in
the circulation resulted in the synthesis of
interferon-á (IFN-á), a well known cytokine. It
was also found that IFN-á was a potent inhibitor
of platelet aggregation (minimal inhibitory dose
≈10nM) similar to that of prostacyclin (PGI2),
currently believed to be the most powerful inhibitor
of platelet aggregation. However unlike PGI2, IFNá was a potent thrombolytic agent that dissoluted
clotted plasma in vitro and fibrinolysed coronary
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
thrombosis in animal model. We investigated the
role of IFN-á in the pathophysiology of the
development of AIHD.
Methods: Fifty patients with acute myocardial
infarction (35 male, 15 female, between 50-68 year
old who were admitted in ICU, Calcutta Medical
College, Calcutta) and 50 age and sex matched
normal volunteers participated in the study. IFNá was determined by enzyme linked
immunosorbent assay (ELISA). Nitric oxide was
assayed by methemoglobin method.
Results: Plasma IFN-á level in normal volunteers
was 17.09±7.49 pmol/ml incontrast the IFN-á level
in AIHD patient was 1.6±0.053 pmol/ml
(p<0.0001). The plasma nitric oxide level in
normal was 0.4±0.02 nmol/h decreased to 0 pmol/
h in AIHD patients. After recuperation the impaired
IFN-á and NO levels in AIHD were found to return
to normal level.
Conclusion: Severe reduction of IFN-á synthesis
due to the decreased synthesis of NO resulted in
the impaired thromboprotection by the cytokine
in AIHD. And, as such the decreased plasma IFNá level might be a hither to unrecognized risk factor
for AIHD in men.
Abstract No: 5.5
Atherogenic Index in Patients with Established Myocardial Infarction.
Abdul Lateef , Afshan Rafi and Pragna Rao
Department of Biochemistry, Kamineni Institute of Medical Sciences, Narketpally,508254.AP.
[email protected]
Introduction: Atherogenic Index defined as
log(TG/HDL-c in mmol/l) has recently been
proposed as a marker of atherogenicity.An
abnormal ratio of Triglycerides(TG) to HDL
indicates an atherogenic lipid proûle and a risk
for the development of Myocardial infarction.
Objective: To estimate and compare the
Atherogenic Index in patients diagnosed with MI
with that of controls.
Methods: 100 Patients attending cardiology
department with symptoms of Acute MI with high
Cardiac Troponin T(cTnT) were selected as
patient group, and healthy subjects were selected
as
control
group.
Serum
Total
Cholesterol(TC),HDL and TG were measured
using COBAS INTEGRA, and cTnT by using
COBAS E411 Electrochemiluminescence.
Results: Patients were divided into 3 groups
depending
upon
cTnT
levels.
172
Group1(controlgroup):cTnT<0.010ng/ml
Group2:cTnT
upto
0.1ng/ml
and
Group3:cTnT>0.1ng/ml. In Group1:The Mean and
SD of Atherogenic Index was 0.22±0.18,
TG:135.31±46.21mg/dl, TC:149.85±34.09mg/
dl,HDL: 33.69 ± 6.87 mg/dl. In Group 2:
Atherogenic Index was 0.36 ± 0.22, TG: 222 ±
119.73 mg/dl, TC: 204.69 ± 56.70 mg/dl., HDL:
35.69 ± 5.10mg/dl. In Group3: Atherogenic Index
was 0.32 ± 0.14, TG: 180.45 ± 56.69mg/dl, TC:
181.96 ± 48.35 mg/dl., HDL: 34.66 ± 5.67mg/dl.
Atherogenic Index was significantly increased in
patients with microinfarcts (p<0.0001) when
compared with normals.Patients with frank infarcts
had higher Atherogenic Index when compared to
patients with microinfarcts.( p>0.05 ).
Conclusion: Other than serum choleterol levels,
elevated triglcerides and lower HDL significantly
contribute to elevated atherogenecity and increase
the risk of MI.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 5.6
Increased Cardio Metabolic Risk Factors seen in School Cildren
Sumathi, Meera , Vinodhini , and Ebenezer William
SRM Medical College Hospital & Research Centre, Potheri.
Objective: To study the occurrence of metabolic (p<0.001) in obese children than in controls. The
risk factors in obese children compared to healthy levels of total cholesterol, triglyceride and LDL
were significantly increased (p<0.001) among the
children.
obese. HDL level was significantly decreased
Methods: School children aged 8 – 15 years (n= (p<0.001) in obese than the controls. The insulin
150) from diverse socio economic background level in obese group showed significant positive
were studied. Demographic, social and medical correlation with Body mass index, Waist hip ratio
details were obtained, anthropometry and blood and total cholesterol, thus indicating insulin as a
pressure were measured. Fasting plasma glucose, component of lipid and glucometabolic risk factor.
insulin and lipid profile were measured.
Conclusion: Obese children showed higher
Results: 65% of obese children showed abnormal prevalence and clustering of abnormality compared
values for one or more cardio metabolic risk to controls. The final conclusion is obese children
factors. (i.e., fasting plasma glucose, lipids and are at an increased risk for the development of
insulin). Obese children had higher prevalence cardiovascular events at an earlier age compared
and clustering of abnormalities compared with to non obese children.
normal children. The levels of fasting blood
glucose and insulin were significantly elevated
Abstract No: 5.7
Assessing Risk Factors in Acute Coronary Syndrome
Moushumi Lodh*, Ashok Parida* and Alpana Saxena**
*Dept of Biochemistry and Dept. of Cardiology, The Mission Hospital, Durgapur; **Dept. of
Biochemistry, MAMC & LN Hospital, New Delhi.
Objectives: PAPP-A and PlGF are abundantly
expressed in ruptured and eroded plaques. PAPPA, a matrix metalloproteinase, stimulates IGF-1
and is said to have pro atherosclerotic action.
PlGF, a member of VEGF family, expressed from
inflammatory cell types , stimulates pathological
angiogenesis. The goal of this study was to
determine predictive value of PAPP-A, PlGF in
acute coronary syndrome and to look for
relationship with markers of myocardial necrosis
(CKMB, troponin I), inflammation (hsCRP,
leptin).
Methods: 100 clinically diagnosed acute coronary
syndrome patients with angiographically
documented significant coronary artery disease
were evaluated within a few hours of reporting to
emergency department with chest pain.
Comparisons were made with 60 age matched
normal healthy controls . Patients of advanced
kidney or heart failure , major surgery/trauma
within the previous month, known inflammatory
diseases, suspected thrombotic disorders were
excluded. Serum PAPPA, PlGF, Lp (a), hsCRP
and leptin levels were assayed , correlations
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
checked with quantitative troponin I and CKMB pregnancy associated plasma protein A levels
mass levels.
showed significant correlation with hsCRP
levels(p<0.05).
Results: Mean hsCRP , PAPP-A, CKMB mass
and Troponin I levels showed significantly higher Conclusions: Elevated PAPP-A and PlGF levels
levels in cases compared to controls. PlGF levels in ACS patients may reflect instability of
in patients was higher but the difference was not atherosclerotic plaques. They may be an early
statistically significant. In the patient group, serum indicator of ACS .
Abstract No: 5.8
Atherogenic Index of Plasma in Ischaemic Heart Disease Patients.
Phani M.N, Supriya .M, Kavya R, Jeevan K Shetty and Mungli Prakash
Department of Biochemistry, Kasturba Medical College. Manipal, India-576104. E-mail id:
[email protected]
Objective: Atherosclerosis is the common cause
for ischaemic heart disease (IHD) and the mortality
and morbidity related to it. There are various
indicators to predict the risk for development of
atherosclerosis. The aim of our present study was
to measure atherogenic index of plasma (AIP) and
TC/HC ratio in IHD patients and to check the
relationship between them.
Methods: Serum lipid profile, AIP and TC/HC
ratio was estimated in 32 IHD patients and 32
healthy controls. Lipid profile was analyzed by
auto analyzer and TC/HC was calculated. AIP was
calculated using formula log [TG/HDL-C].
Results: There was significant increase in TC, TG,
LDL-C, AIP, TC/HC (p<0.001) and significant
decrease in HDL (p<0.001) in cases compared to
controls. Significant positive correlation was
observed between AIP and TC/HC.
Conclusion: According to our study IHD patients
are more prone to the development of
atherosclerosis due to high TC/HC ratio and AIP
when compared to healthy controls. AIP can
predict the size of LDL particle and high LDL
levels and size are important factors in
development of atherosclerosis. Along with TC/
HC, AIP can also be used in routine laboratory to
predict the risk for development of atherosclerosis
in IHD patients.
Abstract No: 5.9
Current Biomarkers for Myocardial Infarction
Rathish R* and Sumathi P
Department of Biochemistry, SRM Arts and Science College, Kattankulathur, Kanchipuram – 603
203 Tamil Nadu.
Objective: Ischemic heart disease is the leading
cause of death in developed countries, but third
to AIDS and lower respiratory infections in
developing countries. Myocardial infarction (MI)
is a common presentation of ischemic heart
174
disease or coronary artery disease. The current
study focused on the lipid profile patterns and
cardiac biomarker levels in MI patients and role
of lipid profile and biomarkers with the risk of MI.
Role and sensitivity of Troponin I over other
Indian Journal of Clinical Biochemistry Supplement, 2009/24
biomarkers. The study was carried out in three in comparison with other groups. MI prone subjects
groups: normal subjects, MI prone subjects and were found to have discordant biomarker levels in
MI patients.
their blood with normal Troponin I, SGOT levels
and elevated CK, CKMB levels.
Methods::Lipid profile and cardiac biomarkers
like Troponin I, CK, CKMB, SGOT were analyzed Conclusion: The present study reveals that MI
in all three groups.
prone patients can be detected by their lipid profile
patterns and discordant biomarker levels. From
Results: The lipid profile patterns were found to these results, it could be concluded that Troponin
be significantly high in MI patients and MI prone I is specific and sensitive to cardiac damage, can
category. MI patients were found to have elevated be used for the detection of MI and CVD risk.
Troponin I levels (80 fold) and other biomarkers
Abstract No: 5.10
Appearance of Dermcidin, a Heat Shock Protein, as a Risk Factor for Acute Ischemic
Heart Disease through the Inhibition of Pancreatic Insulin Synthesis
Rajeshwary Ghosh and Asru K. Sinha*
*Sinha Institute of Medical Science and Technology, 288 Kendua Main Road, Baishnabhghata, Garia,
Kolkata-700084, E mail- [email protected]
Objective: The occurrence of hyperglycemia is
commonly associated with acute myocardial
infarction and unstable angina. The association
of hyperglycemia is reported to result in the worst
prognosis of the functional recovery in this
condition. The mechanism in hyperglycemia in
AIHD remains obscure. We investigated the role
of an inhibitor in the circulation in AIHD for the
inhibition of glucose induced pancreatic insulin
synthesis.
Methods: The synthesis of insulin was determined
by in vitro translation of the isolated mRNA from
the islets of Langerhans from the mice pancreas
exposed to glucose and determined by enzyme
linked immunosorbent assay (ELISA).
Results: The treatment of the islets of Langerhans
with the plasma from AIHD patients but not with
the plasma from normal volunteers in the presence
of glucose resulted in the inhibition of insulin
synthesis from 0.148µunits of insulin /mg of islets/
h in the control experiment to 0.012 µunits of
insulin /mg of islets/h in the presence of AIHD
plasma. This inhibitor from the AIHD plasma was
isolated by preparative SDS gel electrophoresis.
The isolated protein band (14kD, a single
polypeptide chain) that was found to inhibit
glucose induced insulin synthesis was determined
to be Dermcidin isoform 2, an oxidative stress
protein by the amino acid sequence analysis.
Conclusion: The appearance of Dermcidin in the
circulation in AIHD, would superimpose a
prothrombotic condition over the existing AIHD
through the impairment of insulin which is
established to be a potent antithrombotic hormone
in recent time.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 5.11
Uric Acid Levels in Cardiovascular Disease
Mrs. Ranjita V.Gaur, Dr.(Mrs.)Rita M.Shah
e mail id :[email protected] / atmiya04yahoo.com
Objective: The purpose of this study was to see
the relationship of elevated serum uric acid level
in cardiovascular disease.
(>8.41mg/dl) had significantly higher than
females (>6.73mg/dl). Mean SUA.
Conclusion: Our data suggest that increased serum
Methods: The study has been carried out in Dhiraj uric acid levels are independently and significantly
General Hospital, Pipariya, Baroda with known associated with risks of cardiovascular disease
case of cardiovascular disease in 100 patients.
mortality.
Results: Cardiovascular events occurred in 10%
0f patients. In males Serum uric acid level
Abstract No: 5.12
Effect of a Single Dialysis Session on Plasma Lp(a) Levels in Patients on Maintenance
Haemodialysis
Seshadri Reddy. V1, M.M. Suchitra1, E. Prabhakar Reddy1, Aparna R.Bitla1, V. Sivakumar2
and P.V.L.N. Srinivasa Rao1
Department of Biochemistry1, Department of nephrology2, Sri Venkateswara Institute of Medical
Sciences, Tirupati, A.P, India.E-mail: [email protected]
Background: Cardiovascular disease (CVD) is a
major cause of mortality in End stage renal disease
(ESRD) patients on Maintenance haemodialysis
(MHD). Lp (a), is a specialized form of
glycoprotein-LDL-cholesterol complex and is an
independent risk factor for myocardial infarction.
The risk is related to its atherogenic and
thrombogenic properties.
Lp(a) were estimated on Beckmann CX9 Fully
Automated Analyzer using commercial kits.
Statistical analysis was performed using SPSS for
windows version 11.5.
Results: Results of analysis of variance for
repeated measures after correction for
hemoconcentration where necessary revealed a
decrease in Lp(a) (p=0.022) and triglycerides
Objective: The present study was taken up to (p=0.001) levels and no change in cholesterol
evaluate changes in Lp(a) and Lipid profile in (p=0.48) levels.
patients undergoing hemodialysis session.
Conclusion: Maintenance dialysis program is
Methods: Twenty seven patients with end stage known to produce Dyslipidemia. Study of Lp(a)
renal disease who were on maintenance in dialysis patients is important as this is an
hemodialysis were included. Plasma samples were independent risk marker. However there are very
collected hourly during a dialysis session with few reports on changes in Lp(a) due to the dialysis
polysulfone membrane using bicarbonate session. Our findings will be discussed in
dialysate. Plasma cholesterol, triglycerides, and comparison with other reports.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 5.13
Association of LDL Particle Size with other Cardiovascular Risk Markers in an
Industrial Population.
Mohammad Tarik, Lakshmy Ramakrishnan, Ruby Gupta, Dorairaj Prabhakaran , and Kolli
Srinath Reddy
Department of Cardiac Biochemistry, All India Institute of Medical Science, New Delhi-29. Email:
[email protected]
Objective:LDL is heterogeneous in terms of size,
density, electric charge and chemical composition
with some particles of LDL (small dense LDL
particle) showing greater atherogenecity
compared to other particles. Studies on LDL
heterogeneity are not available in resident Indians.
Since data is not available in Indians it would be
pertinent to look at LDL heterogeneity in a resident
Indian population and look at their association
with other known biochemical risk factors of CAD
like lipids, Apo A, Apo B, Lipoprotein (a) and
hsCRP.
Methods:183 employees of an industry in Delhi
with age range 30 -39 years were screened for their
LDL particle size in plasma by 3% polyacrylamide
gel electrophoresis. Their lipids, Apo A, Apo B,
Lipoprotein (A) and CRP were estimated. The
study included 140 males and 43 females.
Results: 41 males (29.3%) and 11 females
(25.6%) had LDL particle size less than 26.3 nm.
The group with LDL particle size d” 26.3 nm
(pattern B) (n=52) were compared with the group
having LDL particle size > 26.3 nm (pattern A)
(n=131). Females with particle size d” 26.3 had
significantly higher total cholesterol, LDL-c,
lipoprotein (a) and hsCRP than females with
particle size > 26.3 nm. Among males, Apo B was
significantly higher in the d” 26.3 group. Apo B,
lipoprotein (a) and
hsCRP was significantly
higher in the < 26.3 group when males and females
were combined.
Conclusion:A high prevalence of small dense LDL
(particle size < 26.3 nm) was observed in the
industrial population studied. There was a
significant difference in lipid parameters in the
subjects with the A and B phenotype. This confirms
that the atherogenic LDL particle size (pattern B)
is associated with other cardiovascular risk factors
in Indians.
Abstract No: 5.14
A Novel Antihypertensive Protein Hormone from the Kidney Cortex, and its use
for the Diagnosis of Essential Hypertension in Men.
Somashree Chakraborty, Gausal A. Khan, and Sinha A.K*
Sinha Institute of Medical science and Technology, 288 Kendua main road, Baishnabghata, Garia,
Kolkata-700084, E mail- [email protected]
Objective: Essential hypertension, the form of
hypertension in men, is a major risk factor for
coronary artery disease (CAD). No etiological
reasons, no gene or any definable cause for
essential hypertension is currently known. And,
as such, there is no diagnostic test for the condition
which,by itself does not produce any discernible
symptom in the victims. We have recently reported
the existence of an antihypertensive protein
hormone produced in the kidney cortex and named
the protein “cortexin”.
177
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: To determine whether of plasma
cortexin level in humans will provide a diagnostic
test for essential hypertension, blood samples from
the persons with established essential hypertension
and age and sex matched normotensive subjects
were collected. Cortexin level was determined by
enzyme-linked immunosorbent (ELISA) assay
using anticortexin antibody. NO was determined
by the formation of methemoglobin.
cortexin, originally was identified in the goat
kidney cortex, cortexin was found to occur in the
blood of all animals including men. It was found
that plasma cortexin level as determined by ELISA
in normotensive persons was 218.94 pmol cortexin/
ml (n=50) that contrasted 0 pmol cortexin/ml in
person with established essential hypertension
(n=50) (p<0.00001).
Conclusion: These results indicate that the
Results: Cortexin was found to normalize elevated determination of plasma cortexin level in men may
blood pressure both systolic and diastolic pressure be useful in the diagnosis of essential hypertension
through the activation of endothelial nitric oxide in man.
synthase (NOS) in animal model. Although
Abstract No: 5.15
Ischemia Modified Albumin – an Evolving Diagnostic Marker of Myocardial
Ischemia
Dr Sudeshna Behera and Prof. P.C.Mohapatra
Department of Biochemistry , S.C.B. Medical College, Cuttack, Orissa, INDIA; Email id –
[email protected]
Background: Establishing a diagnosis of Acute
Coronary Syndrome (ACS) in clinical setting
remains a challenging task. Currently cardiac
markers like Myoglobin, Cardiac Troponin T
(CTnT) and CK-MB are commonly used in
assessing cellular necrosis in patients attending
emergency department with symptoms of acute
chest pain. However there is no accepted gold
standard for detecting myocardial ischemia. So it
is difficult for the clinicians to prevent the
progression of myocardial ischemia to irreparable
myocardial damage. Recently a new marker
Ischemia Modified Albumin ( IMA ) has been
introduced as a highly sensitive and early
detectable marker of myocardial ischemia.
Objective: The present study was conducted to
evaluate serum IMA concentration in acute
coronary syndrome patients and to assess its
diagnostic importance in cases of suspected
myocardial injury.
Methods: The study evaluated IMA in conjuction
with ECG and CTnT in thirty five ACS patients
178
presenting to the emergency department within 3
hrs of acute chest pain. thirty healthy volunteers
served as control. The levels of IMA were
determined by Albumin Cobalt Binding (ACB) test
and readings were taken at 470 nm by
spectrophotometer. Serum MDA and Vitamin E
levels were also assessed in all patients.
Results: Serum IMA levels were observed to be
significantly raised (P<0.05) in acute coronary
syndrome patients than controls. Rise in IMA
demonstrated an association with MDA and
Vitamin E revealing its genesis due to oxidant
stress. The high sensitivity of IMA alone as well
as in combination with ECG and CTnT makes it a
better and an early diagnostic marker of
myocardial ischemia.
Conclusion: IMA can be measured accurately ,
reliably and within an acceptable time period to
be useful in the evaluation of patients with ACS.
It could bring a new dimension to the care and
management of patients at an early stage.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 5.16
Study of Serum Magnesium, HbA1c , Lipid Profile and Microalbuminuria in Diabetic
Retinopathy
Swetha N.K, and Virupaksha H.S.
Dept of Biochemistry , J S S Medical College Mysore-15,Karnataka;
Email id:[email protected]
Background: Diabetic retinopathy is a sight
threatening complication of diabetes mellitus and
is one of the leading causes of acquired blindness.
There is a series of risk factors related to the
development and progression of diabetic
retinopathy such as hypomagnesemia,
dyslipidemia, duration of diabetes, poor diabetes
control.
Objective: 1. To estimate serum magnesium,
HbA 1c , total cholesterol, triglyceride and
microalbuminuria in type II diabetic patients with
and without retinopathy. 2. To compare and see if
there is any significant correlation between these
parameters in diabetic patients with retinopathy.
3. To compare the levels of these parameters with
the healthy volunteers.
Methods: The study included 30 diabetic patients
with retinopathy, 30 diabetic patients without
retinopathy and 30 healthy controls. Serum
magnesium, HbA1c, total cholesterol, triglyceride
and microalbumin in urine were estimated.
Results: There was a significant increase in the
FBS, HbA1c and microalbumin in urine in diabetic
patients with retinopathy and also in diabetic
patients without retinopathy, when compared to the
control group. There was a significant decrease in
the serum magnesium levels in the diabetic groups
when compared to the controls. However there was
no significant variation in the total cholesterol
levels in the study groups. The severity of diabetic
retinopathy in the studied groups was influenced
by factors such as duration of diabetes mellitus,
good glycemic control, hypomagnesemia and
microalbuminuria
Abstract No: 5.17
The Effects of Kidney Function and Transplantation on Biochemical Correlates of
Cardiovascular Health
Thompson. M.J.W. 1 and Ray1.U.
1,2
, University of Tasmania, Hobart, Australia1; Royal Hobart Hospital Hobart, Tasmania, Australia2.
Background: It is consistently now being
appreciated that chronic renal dysfunction alone
is an independent risk factor for the development
of coronary artery disease, and for more severe
coronary heart disease (CHD)[1,2,3,4]. One in
seven Australians show signs of chronic kidney
disease (CKD). CKD is a potent, independent risk
factor for cardiovascular disease (CVD). Risk of
CVD is directly proportional to degree of kidney
impairment. As well as independently increasing
the risk of CVD, kidney dysfunction also adversely
impacts upon other biochemical determinants of
cardiac health. Kidney impairment increases total
cholesterol (TC), triglycerides (TG), low density
lipoprotein (LDL), urates & decreases high density
lipoprotein (HDL). It has also been suggested that
kidney impairment induces a state of insulin
resistance in the absence of pre-existing diabetes
179
Indian Journal of Clinical Biochemistry Supplement, 2009/24
mellitus or other comorbidities know to cause
insulin resistance. Insulin resistance results in
resulting in impaired glucose metabolism and
hyperglycaemia, further worsening CVD risk
profile. These biochemical derangements are seen
in even the earliest stages on kidney impairment.
Thus kidney function has an important role in
maintaining cardiac health. Optimal treatment for
end-stage kidney failure (ESKF) is kidney
transplantation. Previous studies have shown a
decrease in CVD risk in patients who underwent
kidney transplantation compared those patients
who did not. However, CVD risk in patients who
receive a transplanted kidney remains elevated
above the general population. We propose that
improved plasma lipid profile and reduced
inflammation may contribute to this decrease in
CVD risk.
Objective: To examine the relationship between
kidney function, lipid profile and urate and see
how these are affected by kidney transplantation
in non-diabetic patients with ESKF.
Methods: We conducted a retrospective analysis
of non-diabetic patients (M= 15, F= 7, Age = 1972) who had received a kidney transplant within
the last ten years at the Royal Hobart Hospital.
Patients with diabetes were excluded on the basis
of request notes and clinical history. Only patients
who had baseline measurements prior to
transplantation and post transplantation
measurements were included in the study.
Results: HDL decreased with increasing degree
of kidney dysfunction (p<0.0001) with even mild
degree kidney impairment impacting negatively
on HDL (p= 0.006). LDL, TC, TG & urate
increased with increasing degree of kidney
dysfunction (p<0.0001), despite statins use in
>90% of patients. These were seen to increase
even in mild stage kidney failure (p<0.0001).
Kidney transplantation resulted in a statistically
significant increase in HDL (Student’s t-test,
180
p<0.001) and also decreased TG levels (Student’s
t-test, p= 0.014) when compared to pretransplantation levels. LDL, TC & urate were also
decreased following kidney transplantation,
however the effect was not significant. Data were
also analysed using Piecewise 3-step regression
to examine temporal trends in HDL, LDL, TG, TC
and urates in pre- and post-transplant subjects.
Conclusion: Kidney impairment results in
changes to lipid profile and inflammatory status
that negatively impact on cardiovascular disease
risk. Changes in lipid profile and inflammatory
status are observed even in the earliest stages of
kidney failure. Kidney transplantation has a
positive effect on inflammatory status & lipid
profile, particularly HDL.
Reference:
1: Sarnak, MJ, Levey, AS, Schoolwerth, AC,
Coresh, J. Kidney disease as a risk factor for
development of cardiovascular disease: a statement
from the American Heart Association Councils on
Kidney in Cardiovascular Disease, High Blood
Pressure Research, Clinical Cardiology, and
Epidemiology and Prevention. Circulation 2003;
108:2154.
2: Ix, JH, Shlipak, MG, Liu, HH, Schiller, NB.
Association between renal insufficiency and
inducible ischemia in patients with coronary artery
disease: The Heart and Soul Study. J Am Soc
Nephrol 2003; 14:3233.
3: Chen, J, Muntner, P, Hamm, LL, Jones, DW.
The metabolic syndrome and
chronic kidney
disease in U.S. adults. Ann Intern Med 2004;
140:167.
4: McCullough, PA, Nowak, RM, Foreback, C, et
al. Emergency evaluation of chest pain in patients
with advanced kidney disease. Arch Intern Med
2002; 162:2464.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 5.18
Utility of NT proBNP in a wider range
*K.Shanthi Naidu, *Suryadeep Pratap, *Syed Hyder Ali, *BVLN Murthy, * B.Goud,
*B.Raghavendra and *J.Visalasree
Departments of Laboratory Medicine, CARE Hospital, Banjara Hills, Hyderabad – 500034, Andhra
Pradesh
Objective: NT ProBNP is a well known biological
marker of left ventricular dysfunction. The
interpretation of abnormally elevated values threw
light on other cardiac manifestations with variable
clinical presentation.
of cardiac evaluation. Elevation of more than 3 –
5 fold increase was observed in patients of
pregnancy induced hypertension and eclampsia
when compared to a mild increase in normal
pregnancy. Pleural effusion evaluation showed
elevated levels signifying an underlying cardiac
pathology. Patients of renal impairment had
elevated levels and needed aggressive cardiac
evaluation for left ventricular dysfunction. An
increase of natriuretic peptide was also seen in
septic patients.
Methods: Proven diagnosis of 25 patients of
myocardial infarction, 5 of pulmonary embolism,
20 of normal pregnancy, pregnancy induced
hypertension and eclampsia, 10 patients of
dialysis, 25 patients of pleural effusion were
analysed for NT ProBNP on Elecsys (Roche)
Conclusion: NT proBNP widely used for LV
2010/1010.
dysfunction when studied in various clinical
Results: Patients of myocardial infarction had NT manifestations can throw light on asymptomatic
ProBNP in highly elevated and was correlating cardiac conditions calling for a high grade of
with Troponin evaluation. Pulmonary embolism cardiac evaluation.
diagnosed by imaging and D-Dimer showed a
gross increase in absence of left ventricular Acknowledgement: Cardiology, Nephrology, Gyn
dysfunction, suggesting a need for higher grade and Obstetrics and Intensive care units
Abstract No: 5.19
Normalization by Aspirin of Hypertension for the Reduction of Risk of Coronary
Artery Disease in Men
Uttam K. Maji and Asru K. Sinha*
Sinha Institute of Medical Science and Technology, 288 kendua Main Road, Baishnabghata, Garia,
Kolkata-700084, E mail- [email protected]
Backgrfound: Hypertension is known to be a
major risk factor for acute ischemic heart disease.
However the normalization of the elevated blood
pressure
using
currently
available
antihypertensive therapy therapeutic regimen
resulted in only 8% decrease in the risk of acute
ischemic heart disease. We have recently reported
that synthesis of cortexin, an antihypertensive
protein hormone in the kidney cortex cell. None
of antihypertensive drug is capable of stimulating
cortexin synthesis. Systemic increase of NO
stimulated cortexin synthesis and acetyl salicyclic
acid (aspirin) stimulates systemic NO synthesis
Objective: we determined the effect of oral aspirin
(150mg/75kg) ingestion on the elevated systolic
181
Indian Journal of Clinical Biochemistry Supplement, 2009/24
and diastolic blood pressures. Cortexin was also
found to be a potent inhibitor of platelet
aggregation.
mmHg at presentation were found to become
normalized (123.33±10.30 mmHg systolic,
82.5±5.5 mmHg diastolic respectively) after 3h of
ingestion of aspirin with concomitant increase of
Methods: Newly diagnosed patients with cortexin level from 0 nM (before aspirin ingestion)
hypertension, (n=50) who never received any to 9.23± 0.042nM (after the ingestion) of the
antihypertensive medication at presentation were compound (p<0.0001) in these patients.
asked to participate in the study by ingesting
enteric coated aspirin (150mg/75kg) only after the Conclusion: Since cortexin is reported to be a
participants took a full meal. The blood pressures potent inhibitor of platelet aggregation,and was
were measured after 3h of ingesting the drug. found to be a powerful normalizer of hypertension,
Cortexin was determined by enzyme linked aspirin might be useful for the reduction of risk
factor for CAD both through the normalization of
immunosorbent assay (ELISA).
the hypertension and inhibition of platelet
Results: The both systolic and diastolic pressure aggregation.
which were 160.63±13.85 mmHg, 96.63±8.03
Abstract No: 5.20
A Study of Insulin Levels in Pregnancy Induced Hypertension
Vinodhini, Meera Shivshekar and Ebenezer William
Department of Biochemistry, SRM Medical College Hospital & Research Centre , SRM University,
Potheri, Tamil Nadu
Background: Preeclampsia one of the most
common complications of pregnancy is a major
cause of maternal, fetal and neonatal morbidity
and mortality. Many features of insulin resistance
syndrome have been associated with this
condition. Objective: The aim of this project was
to study the levels of insulin and lipoproteins in
pregnancy induced hypertension (PIH).
Methods: The study included 30 patients with
PIH, 20 patients with normotensive pregnancy and
20 age matched controls.
Results: The mean level of insulin was
significantly elevated in cases of PIH than the
controls (P< 0.001). The levels of total cholesterol,
TGL and LDL were significantly high and HDL
was significantly low among patients with PIH
than the controls.
Conclusion: The result of this study indicates that
insulin resistance plays a role in pathogenesis of
PIH. Such patients are at an increased risk for
future cardiovascular disease. Interventions to
reduce insulin resistance will minimize later life
cardiovascular complications.
Abstract No: 5.21
Levels of GHBA1C in Non- diabetic Patients with Cardiovascular Disease
Tarun Kumar Sharma**, H. Parchwani*, G.G. Kaushik* and Vijay Shankar**
*Department of Biochemistry, J.L.N. Medical College, Ajmer (Rajesthan), **Pt. B.D. Sharma,
P.G.I.M.S., Rohtak (Haryana)
Objective:High levels of GHbA1C traditionally
have been associated with cardiovascular disease
182
(CVD) and diabetic patients. The available data
suggests that an association exists between levels
Indian Journal of Clinical Biochemistry Supplement, 2009/24
of GHbA1C and CVD, even in patients without diabetes. observed 4.32 + 0.34% and 5.80 + 0.20%
respectively. GHbA1C levels in these subjects were
Methods: The present study was conducted on significantly higher than
healthy controls (p<0.001).
25 age matched controls and 50 clinically
diagnosed non-diabetic CVD patients of either sex. Conclusion:The results of the study indicate that
elevated GHbA1C level is an independent risk factor
Results:The GHbA1C levels in healthy controls for CVD.
(n=25) and non-diabetic CVD subjects (n=50) was
Abstract No: 5.22
Biochemical Markers and Coronary Occlusion in Patients Undergone Coronary
Arteriography
Bhagwat VR1, Venugopal NT2, Yadav AS3 and Mane AY4
1. Dept of Biochemistry, SBH Govt Medical College, DHULE (Maharashtra), 2. Dept of Biochemistry,
DY Patil Medical College, Kolhapur (Maharashtra), 3. Dept of Biochemistry, MIMSER Medical
College, Latur (Maharashtra), 4. Dept of Biochemistry, RD Gardi Medical College, Ujjain (MP).
Email: [email protected]
Background:Cardiovascular diseases are the
leaders in modern day lifestyle disorders. The risk
factors are multiple and their relationships are
complex. Emerging risk factors should be
compared with established risk factors before its
clinical usefulness can be ascertained.
Objective: This study was done to evaluate the
novel risk factors of coronary artery disease
(CAD) with respect to the degree of coronary
occlusion.
Methods:The study was comprised of 33 patients
who under went coronary arteriography (CAG).
9 had normal coronary, 9 had single vessel block,
while 15 patients had double vessels blocks.
Classic serum lipid profile included total
cholesterol (TC), triglyceride, high density
lipoprotein (HDL), low density lipoprotein (LDL).
Novel serum lipid profile included apolipoprotein
A1, apolipoprotein B and lipoprotein (a) by
immuno-turbidometric assays.
Results: Mean TC, LDL levels and both the
atherogenic indices TC/HDL and LDL/HDL
showed ascending trend when compared between
the groups. Mean Apo A-I in normal vessel group
was highest (155 ± 11.78 mg/dl) while in double
vessel block group it was lowest (135.60 ± 28.50
mg/dl). However, mean lipoprotein (a) level
showed divergent trends from normal coronary
vessel (5.44 ± 3.30 mg/dl), single vessel block
group (13.02 ± 13.30 mg/dl) highest in double
vessel block group (52.87 ± 28.42 mg/dl).
Conclusion:Lipoprotein (a) is a better marker than
LDL which correlated with the degree of occlusion.
Higher Apo A-1 and A1/B ratio are the potential
biochemical markers of anti-atherogenicity while
elevated Lipoprotein (a) appears to be a dangerous
atherogenic force that lead to CAD.
Abstract No: 5.23
Cytomegalovirus and Coronary Heart Disease
Asif. A
School of Health Sciences, Thalassery campus, Palayad, Kannur University [email protected]
Background: The role of viruses and other
infectious agents in the development of
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
atherosclerosis and incident myocardial infarction
and coronary heart diseases has long been an area
of investigative interest. Several risk factors for
coronary artery disease have been well
documented including hyperlipidemia,
hypertension, smoking, diabetes, a positive family
history and obesity. However, these factors explain
only part of attributable cardiovascular disease,
and other factors must be involved.
included in the study. Serum lipid profile and
determination of Anti-CMV Ig-G levels (Enzyme
Immunoassay method) were performed in all the
patients and the values were compared with that
of normal control subjects.
Results: The serum cholesterol and Triglycerides
levels in CHD patients were higher than that of
normal control. The HDL-cholesterol value
obtained was lower in CHD patients. The serum
Objective: To Compare Ig-G levels of the CMV Anti CMV Ig-G levels were also found to be
in CHD patients with normal control subjects to increased in patients with CHD. The all values
find out whether the CMV plays any role in the were found to be statistically significant (P < 0.05).
development of CAD. The present study was
conducted on 20 CHD male patients with age Conclusion: From the findings it may be
concluded that the increased level of Ig-G
ranging from 40 – 70 year.
antibodies to cytomegalovirus was associated with
Methods:Twenty age matched control subjects increased risk of Myocardial Infarction and
who had no past history of any cardiovascular Coronary Heart Disease.
disease, hypertension of diabetes mellitus, were
Abstract No: 5.24
Role of “Ischemia Modified Albumin” in the Early Diagnosis of Acute
Coronary Syndromes
B Gayathri, D Vijaya, B Bini, Usha Anand., V. Aruna and CV Anand
Dept. of Biochemistry, PSG Institute of Medical Sciences &Research, Coimbatore- 641004, Email:
[email protected]
Background: Diagnosis of cardiac ischemia in
patients attending emergency departments (ED)
with symptoms of acute coronary syndromes is
often difficult. Cardiac troponinT (cTnT) is
sensitive and specific for the detection of
myocardial damage but may not rise during
reversible myocardial ischemia. Ischemia
Modified Albumin (IMA) has recently been shown
to be a sensitive and early biochemical marker of
ischemia.
Methods: This study evaluated IMA in
conjunction with cTnT in 150 patients presenting
to the ED with acute chest pain. 10 age and sex
matched healthy volunteers served as controls (non
ischemic individuals). cTnT was assayed in
184
Elecsys 2010 immuno analyzer (Roche
Diagnostics). IMA was estimated by the method
of Bar-Or et al. The values were expressed as mean
± SD and data from patients and controls were
compared using students ‘t’ test.
Results: Patients were classified as ischemic, non
MI ( cTnT ≤ 0.03ng/mL) and MI (cTnT >0.03ng/
mL) Values of IMA, and cTnT, were correlated
with final diagnoses of unstable angina, ST
segment elevation, and non-ST segment elevation
myocardial infarction. The mean absorbance Units
(ABSU) ± sd for control, ischemic non AMI and
AMI groups were 0.3554±0.006, 0.5279±0.116,
0.6259± 0.203 respectively (p<0.0001). In the
whole patient group, sensitivity of IMA at
Indian Journal of Clinical Biochemistry Supplement, 2009/24
presentation for an ischemic origin of chest pain Conclusion: IMA is highly sensitive for the early
was 81%, compared with 82% of ECG and 50% diagnosis of myocardial ischemia in patients
of cTnT. All three tests combined, identified 95% presenting with symptoms of acute chest pain.
of patients whose chest pain was attributable to
ischemic heart disease.
Abstract No: 5.25
Inflammatory Markers in Arterial Prehypertension and Hypertension
∗, D’Souza V∗
∗, Hegde A∗
∗, Adhikari P• and CV Raghuveer♦
♦
Manjrekar AP∗
∗Dept. of Biochemistry, •Dept. of Medicine, ♦Dept. of Pathology, Kasturba Medical College,
Mangalore. Karnataka. Email: [email protected]
Objective: To evaluate inflammatory markers as density cholesterol (LDL) >100mg/dL, Very low
cardiac risk assessors in essential prehypertension density cholesterol (VLDL )>30mg/dL and TC/
and hypertension.
HDL ratio >5.
Methods: 277 undiagnosed subjects were
screened and 45 subjects of age 25-60 yrs. of either
gender met the criteria of prehypertention
(Systolic blood pressure (SBP) 120-139mmHg;
Diastolic blood pressure (DBP) 80-89mmHg) or
hypertension (SBP>140mmHg; DBP>90mmHg).
For this test group, an age matched normotensive
control group was chosen. Waist circumference
(WC) and Body Mass Index (BMI) were measured
and Erythrocyte sedimentation rate (ESR), Total
leucocyte count (TLC), hsC-reactive protein
(hsCRP),
Fibrinogen,
Haptoglobin,
Ceruloplasmin and fasting lipid profile were
estimated. To compute the results the following
cut off values were used; WC>90cms, BMI>24.9,
ESR>20, TLC>7000, hsCRP>3.0mg/L,
Fibrinogen >200mg/dL, Haptoglobin >150mg/dL,
Ceruloplasmin >25mg/dL, total Cholesterol (TC)
>200mg/dL, Triglycerides (TG) >150mg/dL,
High density cholesterol (HDL) <40mg/dL, Low
Results: The nonspecific inflammatory markers
ESR and TLC were not different in the two groups.
All other inflammatory markers, dyslipidemia and
obesity indices were more pronounced in the test
group. Using the cut off points, the percentage
values in the test/control group were; BMI-48.89/
42.22, WC-60/40, hsCRP-28.89/6.67, fibrinogen82.22/68.89,
haptoglobin-35.55/15.56,
ceruloplasmin-48.89/35.55, TC-44.45/ 37.78. TG42.22/ 31.12, HDL-48.89/ 46.67, LDL-84.44/
77.78, VLDL-42.22/ 33.33, and TC/HDL- 51.11/
33.33.
Conclusion: Inflammatory markers are
independent cardiovascular risk predictors. In
conjunction with altered lipid profile and metabolic
indices the risk is manifold. Inflammatory markers
should be considered in the hypertensive workup
and anti inflammatory drugs can be included in
the therapeutic management.
Abstract No: 6.1
A Spectrum of Paraproteinemias
*K.Shanthi Naidu, **P.Srikanth, **Shailesh.S, ***M.R.Chakravarthy *Syed Omar, *Kishore,
*A.Suhasini and *J.Visalasree
Departments of * Laboratory Medicine, ** Consultant Pathologist and Clinical Hematologist, ***
Consultant Nephrologist, CARE Hospital, Banjara Hills, Hyderabad – 500034, Andhra Pradesh
Objective: The conventional serum protein electrophoresis (SPE) has slowly given way to
185
Indian Journal of Clinical Biochemistry Supplement, 2009/24
immunofixation electrophoresis (IFE) which
diagnoses a larger number of paraproteinemias and
the inclusion of serum free light chain analysis,
emphasizes stratification and predictive outcomes
of the disease.
Methods: From September 2008 – June 2009 324
samples, 202 males and 122 females were
subjected to SPE and IFE using Beckman paragon,
binding site and helena electrophoretic gels. Serum
light chain analysis was done on Binding Site kit
adapted to Beckman Coulter Synchron Cx9
clinical system.
Results: Paraproteinemia was detected from was
21% where as the yield from IFE was 36% (IgG
kappa 64.2%, IgG lambda 4.76%, IgM kappa
14.2%, IgA kappa 4.76%). Light chain assays
showed high or low ratios suggesting either
suggesting an increase in either kappa or lambda,
emphasizing a monoclonal pattern.
Conclusion: Analysis of light chain would further
evaluate patients of paraprotein, identify
amyloidosis and has a major role to be used at
discretion when clinical and imagiology was not
diagnostic. Monitoring light chains was of
prognostic significance.
Abstract No: 6.2
Effective POCT : the Need for a Broader Perspective
A.K.Srivastava
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India;
Email : [email protected]
Optimizing all the steps in the testing cycle is as
crucial to the success of point-of-care testing
(POCT) as the measurement process itself. The
complete POCT process or testing cycle is a complex series of events that involve many parties in
any clinical organization. Consultation with all the
people concerned is important and has led to the
formation of institution-wide Point-of-Care Coordinating committee. In recent years, the focus
on developments in point-of-care (POCT) from a
preoccupation with the analytical process to a
broader perspective that takes into consideration
other procedures which take place before and af-
ter the measurement process. This has come after
realization that success with POCT requires optimization of the many different steps that make up
the total testing process or cycle. Outside forces
have also played in this change of focus, particularly those concern with promoting total quality
management and patient safety. As well as ensuring that POCT meets required standards on a dayto-day basis, the role of clinical scientists on the
committee is to ensure that the POCT process continues to meet clinical needs through audit and, if
necessary, changing testing procedures.
Abstract No: 6.3
Biochemical Markers in Osteoporotic Hip Fractures
Dr.Meera.S **, Dr.M.Sukharaja *, Dr.B.G.Sagar # and N.Kantharaj*
Mysore Medical College & Research Institute, Mysore, *Professor & HOD of Biochemistry,
** Associate Professor of Biochemistry, ***Lecturer in Biochemistry, # Professor of Orthopaedics
Background: Osteoporosis is a major metabolic fracture in 40% of aging women and 15% of aging
bone disease which over a lifetime results in hip men. The recognition of osteoporosis as a disease
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
that leads to fracture risk, offers new insights into
its epidemiology. Homocysteine is an amino acid
intermediate formed during the metabolism of
methionine and studies have shown it to be a
strong independent risk factor for hip fracture in
older men and women. The knowledge about risk
factors for hip fracture in Asian population is very
much limited and the mechanism(s) by which
increased levels of homocysteine are associated
with osteoporosis is poorly understood.
Objective: To analyze the homocysteine and other
biochemical parameters such as calcium,
phosphorous, & alkaline phosphatase which will
be compared to the Bone Mineral Density (BMD).
Methods:The present investigation involves new
cases with recent history of hip fractures (n = 50)
and the healthy age and sex matched controls (n=
50). The analysis of the biochemical markers is
done in fasting blood samples by using fully
automated analyzer. Student ‘t’ test is used to
analyze the data. This study will evaluate the role
of these markers in osteoporotic hip fractures.
Conclusion:The present investigation will try to
throw light on the understanding of the
pathophysiology of the Osteoporotic hip fracture
which will help planning preventive strategies with
regard to the incidence of osteoporotic hip fracture
in future.
Abstract No: 6.4
Metabolic Dearrengements in Births Asphyxia Occurring as a Result of Cellular
Injury.
Amrita Vamne*, B. K. Agrawal* and Jyotsana Shrivastava**
*Department of Medical Biochemistry, **Department of Peadiatrics, Gandhi Medical College, Bhopal.
Email address- [email protected]
Background: Birth asphyxia occurs when a body
does not receive enough oxygen before, during or
just after birth. Low serum calcium, glucose and
magnesium values are associated with cellular
injury.
glucose by GOD –POD method.
Results: Serum calcium and glucose were found
to be significantly low in asphyxiated babies
compared to the control group (p<0.001). There
was not a significant impact of asphyxia on
Objective: Present study was undertaken to
magnesium metabolism. The percentage of
estimate values of serum calcium, glucose and abnormal serum calcium, glucose and magnesium
magnesium on 1st, 3rd, and 5th day of life. The
metabolism was found to be increased with the
present study includes 50 asphyxiated and 25
severity of asphyxia in the subjects.
healthy neonates.
Conclusion:It is observed that hypoglycemia and
Methods: Parameters included in the study are 1.
hypocalcaemia are associated with asphyxiated
Serum calcium by OCPC method, 2. Serum
neonates, which may be due to cellular injury.
magnesium by Calmagite method, and3. Serum
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.5
Evaluation of Salivary Cholinesterase and Ceruloplasmin in Children with Attention
Deficit Hyperactivity Disorder
Bhavya Prabhu.K, Archana E, Priya Pai, Dr. Krishnananda Prabhu and Dr. Anjali Rao
Department of Biochemistry, Kasturba Medical College Manipal, India-576104. E mail:
[email protected]
Introduction: Attention Deficit Hyperactivity
Disorder (ADHD) is one of the most frequently
diagnosed childhood psychiatric disorders. Based
on various empirical estimates, symptoms of
ADHD persist into adulthood in about 30-50% of
the childhood cases. Studies have shown RBC and
plasma cholinesterase show unique patterns of
differences in patients with various
neuropsychiatric disorders including ADHD as
compared to controls indicating involvement of
cholinergic system in these disorders. Antagonism
of neuronal nicotinic acetylcholine receptors have
shown to ameliorate the core symptoms of various
neurological disorders associated with
hyperkinesis, attention and memory loss. Patients
lacking circulating serum ceruloplasmin presented
with neurodegeneration. Animal experiments that
showed lack of ceruloplasmin was associated with
redox injury in the brain. Also copper deficiency
has been implicated in neurological impairment
seen in Wilson disease.
Methods: After obtaining clearance from
institutional ethics committee, we estimated
salivary ceruoplasmin (Ravin.H.A et al) &
cholinesterase (Ellman’s method) from 12 controls
& 9 subjects in the age group 5 – 12 yrs and their
values were compared
Results: Pseudocholinesterase showed significant
increase (p< 0.001) in subjects as compared to
controls.Ceruloplasmin levels showed marginal
decrease(p=0.065) in subjects as compared to
controls however it was not statistically significant.
Conclusion: Results show the role for cholinergic
system and ceruloplasmin in ADHD. Also saliva
can be an effective alternative tool for evaluation.
References:
1. J Atten Disord. 2005 Nov;9(2):382-3
2. Psychiatr Pol. 2002 Nov-Dec;36(6
Suppl):133-41
3. Curr Opin Neurol. 2006 Dec;19(6):613-8
Objective:: To estimate salivary ceruloplasmin 4. Biochem Soc Trans. 2008 Dec;36(Pt 6):1277-81
and cholinesterase in children with ADHD & to 5. J Neurol Neurosurg Psychiatry. 2009
May;80(5):524-7
compare their respective values in controls.
6. Pediatr Neurol. 2006 Oct;35(4):284-6
Abstract No: 6.6
Cheek Cell Epithelium: a Non Invasive Specimen for Measurement of
Fatty Acid Intake
Ransi Ann Abraham, Lakshmy Ramakrishnan ,Ruby Gupta, Smita Golandanz, Rajinder
Parshad, V K Bahl, Ambuj Roy, R M Pandey, Dorairaj Prabhakaran and Kolli Srinath Reddy
Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi
[email protected]
Objective:The intake of fat, an essential
macronutrient of diet vary widely among
188
individuals and changes over time. Traditional
dietary assessment methods are prone to errors and
Indian Journal of Clinical Biochemistry Supplement, 2009/24
bias; hence an objective measurement is important
to assess intake. Technical advancements have
made it possible to study fatty acid even from
small tissue samples; hence we have explored the
suitability of using cheek cell epithelium as a
non invasive tissue for assessing dietary fatty acid
intake.
Methods: Blood and cheek cells were collected
from 17 subjects in fasting state at the same time.
Dietary data was collected through 24 hrs recall
and food frequency questionnaire. Lipids were
extracted from cheek cell and serum; fatty acids
converted to methyl esters and were run on GC.
Fatty acids were identified by comparing their
retention time with known standards. Dietary fatty
acid was computed from the food composition
tables.
and 33.06 (4.66) respectively, MUFA was 21.27
(8.75) and 24.76 (3.74) respectively and PUFA was
12.76 (6.04) & 24.52 (3.34) respectively. Palmitic,
stearic and oleic acid were the major fatty acids
identified in cheek cell and serum. There was a
significant correlation between MUFA (r = 0.35)
and arachidonic acid (r = 0.46) values obtained
between serum and cheek. The saturated fatty acids
in cheek cell correlated significantly with dietary
saturated fatty acid (r = 0.52). A correlation of 0.48
& 0.51 was observed for linoleic and total PUFA
in serum and diet respectively. The distribution of
fatty acid varied between serum and cheek cell.
Serum was richer in PUFA which reflected the
dietary intake of the subject, while cheek cell
reflected the saturated fatty acid intake which are
stored as fat.
Conclusion:In conclusion saturated fatty acids in
Results:The % mean (SD) total saturated fatty
cheek can be a good non invasive biomarker for
acids levels in cheek and serum were 35.13 (8.06)
dietary saturated fatty acid intake.
Abstract No: 6.7
Coagulation Deficiencies in a Referral Laboratory
*K.Shanthi Naidu, **P.Srikanth, **Shailesh.S, ***D.Ramesh, #D.Ramana, *B.Raghavendra,
*B.Goud and *B.Siva Mallika
Departments of * Laboratory Medicine, ** Consultant Pathologist and Clinical Hematologist, ***
Consultant Peadiatrician*, ** & *** CARE Hospital, Banjara Hills, Hyderabad – 500034, Andhra
Pradesh, # Rainbow Hospital, Hyderabad, Andhra Pradesh
Objective: Coagulation studies need critical
assessment of standard operative procedures and
quality control. Evaluation of either congenital or
acquired deficiency should always be done where
technical expertise is high and hence no hesitation
to a higher referral center should be debated.
Results: Of 1000 referrals to our hospital
laboratory 252 were abnormal: The following were
identified; factor VIII 173 (68.6%), factor IX 43
(17%), factor V 5 (1.98%), factor X 12 (4.7%),
factor VII 4 (1.6%), factor XIII 2 (0.8%),
fibrinogen 5 (2%), combination of factor V and
Methods: Coagulation studies pertaining to a VIII 2 (0.8%), inhibitors to factor VIII and IX 6 (2.4%).
routine screen of prothrombin time, activated
partial thromboplastin time, fibrinogen, thrombin Conclusion: Appropriate clinical and family
time, factor XIII, platelet and pheripheral smear history narrows down the diagnosis of deficiency.
studies were done on CA 50, Stago ST and Sysmex Mixing experiments further help in aiming at a
4. Bleeding time by modified Ivy’s technique, particular assay, cutting down cost to the patients
where necessary. Mixing experiments and factor and highlighting efficiency of the laboratory in
assays by commercial reagents of Transasia, Stago understanding the sequence of assays to be done.
and Tulip Diagnostics
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.8
Coagulation Studies in Neonatal Critical Care
*K.Shanthi Naidu, *P.Srikanth, **Shailesh.S, ***D.Ramesh, #D.Ramana,*B.Raghavendra,
*B.Goud, *B.Siva Mallika and *S.M.Ismail
Departments of * Laboratory Medicine, ** Clinical Hematology, *** Peadiatric*, ** & *** CARE
Hospital, Banjara Hills, Hyderabad – 500034, Andhra Pradesh, # Rainbow Hospital, Hyderabad, Andhra
Pradesh
Objective: Altered hemostatic parameters both
coagulation and platelets in neonates is a call for
immediate attention, being a critical issue.
Understanding the normal reference range in this
group is essential prior to labeling a disorder.
Methods: 150 samples over a period of 2 years
studies for peripheral smear, platelets, prothrombin
time(PT), activated partial thromboplastin
time(APTT), fibrinogen and thrombin time(TT)
were assayed on Sysmex analyzer, CA 50 and
Stago ST 4. Factor XIII was done by urea clot
lysis time.
Results: Abnormal PT and APTT were seen in
38%, low fibrinogen levels in 10.8%. Factor XIII
abnormality was mainly due to low fibrinogen
levels preventing a clot formation. Hemorrhagic
disease of the new born was 34%. All studies were
done on follow up to confirm this. Factor VIII and
factor IX deficiencies were retested over a period
of 6 months to one year for confirmation unless
the history and clinical presentations identified a
congenital deficiency.
Conclusion: Close monitoring of neonates for
coagulation studies is related to the process of
phlebotomy and the specific reference range very
different from the adult. Deviation from this
protocol would mislead in over diagnosing simple
variability by a large protocol of workup.
Abstract No: 6.9
A Case of Xanthochromia
Ashish Sharma, N. Haridas, S. Ghosh, Hitesh Shah ,Kiran and Uday
Department of Biochemistry, P.S. Medical College,Karamsad Anand, Gujarat
Sub arachnoid hemorrhage detection is very crucial in patients. SAH can develop due to varied
etiologies. A computerized tomography (CT) scan
is positive in up to 98% of patients with SAH presenting within 12 h, but is positive in only 50% of
those presenting within first week. Here we are
presenting a case having a history of road traffic
accident, came to our hospital after three weeks
of RTA with CT finding inconclusive at admis190
sion. Patient had continuous headache and neuropsychiatric symptoms. Biochemical analysis of
CSF revealed increased level of bilirubin (xanthochromia) which was suggestive of Sub arachnoid
hemorrhage. In this way biochemical CSF analysis is important in diagnosis and therapeutic selection of patients for angiography and preventative surgery.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.10
Abstract No: 6.11
The Potential Significance of Procalcitonin and Interleukin-6 in Prediction of
Survival in Patients with Sepsis
S. Das, S. Bhargava, A. Manocha, M. Kankra and L.M.Srivastava
Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, India
Objective: Appropriate treatment of sepsis relies
on early and correct diagnosis and contributes to
reduced morbidity and mortality. Procalcitonin
(PCT) is a proposed specific marker of the
systemic inflammatory response to infection and
interleukin-6 (IL-6) is a proinflammatory cytokine
induced by many mediators. Our objective is to
determine the relationship between levels of serum
191
Indian Journal of Clinical Biochemistry Supplement, 2009/24
PCT and IL-6 in patients with sepsis and their
prognostic outcome.
Methods: ICU patients with suspected infection
and fulfilling at least two criteria of systemic
inflammatory response syndrome were studied.
PCT and IL-6 were measured on admission (0
hour), 24 hours and 72 hours and their levels
compared in surviving and non surviving patients.
non survivors as compared to survivors. However,
PCT levels decreased significantly (p=0.003) in
58% of surviving patients over a period of time
(0-72 hours) as compared to 29% in non surviving
group. The difference in IL-6 levels between
survivors and non survivors was not statistically
significant.
Conclusion: Significant decreasing levels of PCT
as compared to non significant decrease of IL-6 in
Results: The median value of PCT and IL-6 were
survivors with respect to non survivors were
significantly high (p=0.000 - 0.032) in non
associated with a higher probability of survival.
surviving patients as compared to patients who
Hence, time dependent monitoring of PCT
survived. The acute physiology and chronic health
concentration might provide an earlier indication
evaluation and sequential organ failure assessment
on the chances of survival.
scores were also significantly (p=0.000) high in
Abstract No: 6.12
Immunological Studies on Glycated and Glycoxidated LDL: Implications in the
Pathogenesis of Various Diseases
Salman K A1, Alam R1, Arif N2 and Khan S1
Department1 of Biochemistry, JN Medical College, Aligarh Muslim University and Department2 of
Chemistry, Z H College, New Delhi.
Background: The entry of glucose into the brain
and peripheral nerve tissue, kidney, intestine, lens
and RBC does not depend on insulin action.
During hyperglycemia, intracellular level of
glucose in these cells is high. This promotes nonenzymatic attachment of glucose to protein
molecules (Protein Glycation). Glycation of
proteins leads to the formation of AGE’s
(Advanced Glycation End product) of diverse
molecular structure and biological functions. AGE
cross-links body proteins such as tissue collagen
or a nerve protein-myelin, lens crystalline. AGE
formation stiffens the extracellular matrix and
decreases the elasticity of, for instance the arterial
wall. Their formation also affects the function of
endothelial cells, phagocytes (macrophages) and
smooth muscle cells in the wall of blood vessels.
Through these mechanism AGE may contribute
to the development of the late complication of
diabetes other vascular diseases, aging and
rheumatoid arthritis.
192
Objective: The basic objective of this study is to
evaluate the level of glycated and glycoxidated
LDL in the sera of patients with vascular diseases
and diabetes.
Methods: Commercially available LDL was
modified by glucose and peroxynitrite generated
by SIN-1. The degree of LDL modification was
assessed by various physical and biochemical
parameters.
Results: Serum autoantibodies against native,
glycated and glycoxidated LDL was evaluated
in patients of cardiovascular diseases and diabetes.
The results showed the presence of high levels of
autoantibodies against glycoxidated LDL as
compared to native and glycated LDL.
Conclusion: Such research also will increase the
understanding of how AGES cause pathology and
the extent of AGE involvement in the various
complications of diabetes and vascular diseases.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.13
Critical Call Back – An Experience in a Tertiary Care Hospital
Dr. Mohammad Ibrahim1, Maj Dr. Ikramul Islam (Retd) 2, Prof (Dr.) Tareak-Al-Nasir3, and
Lt.Col Dr. Debashish Saha4
1.Senior Registrar, Clinical Biochemistry, Lab Medicine Department Apollo Hospitals Dhaka,
Bangladesh. 2.Senior Registrar, Clinical Pathology and Hematology, Lab Medicine Department Apollo
Hospitals Dhaka, Bangladesh. 3.Senior Consultant and Coordinator Lab Medicine Department Apollo
Hospitals Dhaka, Bangladesh. 4.Classified specialist in Pathology CMH Bogra Cantonment, (ExConsultant, Clinical Biochemistry, Lab Medicine Department Apollo Hospitals Dhaka). Bangladesh
Critical value reporting originally was highlighted
by Dr. Lundberg, who defined a critical value as
a result suggesting that the patient is in imminent
danger unless appropriate therapy is initiated
promptly. Reporting of laboratory critical values
has become an important issue for patient safety
as described in the National Patient Safety Goals
of the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO).The recent
focus on patient safety has brought increased attention to the issue of laboratory critical value
reporting. Critical value reporting parameters may
be considered an important laboratory outcome
measurement because they reflect clinical effectiveness, patient safety, and operational efficiency.
For the critical value reporting process to be effective, the organization must understand and address the variables involved in the process. Herein,
we report the results of an analysis of 4260 consecutive laboratory critical values from July 2007
to December 2008 at our institution, a Joint Commission International accredited Tertiary care hospital to understand the scope of critical value reporting and identify opportunities for process improvement. We evaluated critical value reporting
by parameter, laboratory specialty, clinical care
area, time of day, and Turn around Time. Factors
leading to delays in critical value reporting are
identified, and we describe approaches to improving this important operational and patient safety
issue. We are proud to be the pioneer in Bangladesh
to introduce the system of Critical Call Back in
Lab medicine of Apollo Hospitals Dhaka which
was highly appreciated by the survey team of Joint
Commission on Accreditation of Healthcare Organizations (JCAHO) during our accreditation process
Abstract No: 6.14
Rare cases of Pagets Disease of the Bone in India: Biochemical and Clinical
Evaluation and Follow-up in 2 Extreme Presentations
Dr CS Muralidhara Krishna ,Dr H L Vishwanath ,Dr S Sanjay, Dr Tejeswini Deepak, Dr A
Sharda and Dr SS Srikanta
Endocrinology and Diabetes Study Group, Samatvam and Jnana Sanjeevni Medical Center, and Dept
Biochemistry, Bangalore Medical College, Bangalore, India
Paget disease is a localized disorder of bone
remodeling that typically begins with excessive
bone resorption followed by an increase in bone
formation. Approximately 70-90% of persons
with Paget disease are asymptomatic and detected
based on the incidental finding of an elevated
serum alkaline phosphatase (SAP) level or
characteristic radiographic abnormality However,
a minority of affected individuals experience
various symptoms, including bone pain (the most
common symptom), secondary osteoarthritis, bony
deformity, and neurologic complications.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Although the etiology of Paget disease is
unknown, both genetic and environmental
contributors have been suggested. Ethnic and
geographic clustering of Paget disease is well
described. An environmental trigger for Paget
disease has long been considered but never proven
- viruses. Paget disease is estimated to occur in
1-3% of individuals older than 45-55 years and in
up to 10% in persons older than 80 years – Europe.
Paget disease is very rare in Asian countries,
especially India.
Bisphosphonates (eg
alendronate 40 mg/d PO for 6 mo) are first line
therapy - analogs of pyrophosphate, act by binding
to hydroxyapatite in bone matrix, thereby
inhibiting the dissolution of crystals.
Case 1: DS, 53 year male, was found (year 2008)
to have unexplained asymptomatic elevation of
SAP 625, 908, U/L (53-128), during a routine
annual diabetes health review; Pagets disease –
polyostotic was confirmed by isotope bone scan
(skull, vertebra, pelvis, femur, tibia, scapula,
sternum) and radiology; he was treated with the
initial cycle of alendronate ; during and after
therapy serial SAP levels decreased to 786, 521,
299 and 136U/L.
Case 2: BN,63 year female presented (year 2002
) to an orthopedic surgeon with severe L iliac bone
pain, leading to x ray studies - lytic bone lesions,
isotope bone scan, bone biopsy and a histological
diagnosis of “malignancy” – metastases from an
unknown primary - erroneous. Review by
endocrinologist established the diagnosis of Pagets
diseases – polyostotic (skull, vertebra, pelvis,
femur), SAP level of 1343,954,835. She received
two 6 months cycles of alendronate therapy in
years 2003 and 2007 (Serial SAP; Year
2003=130,168;Year
2004=232;Year
2005=322,Year 2006=339 ,Year 2007=575,Year
2009=65).
Abstract No: 6.15
Role of Acute Phase Proteins in the Prognosis of Head Injury
P Sumathi and M K Balasubramanian
Department of Biochemistry, SRM Arts and Science College, Kattankulathur – 603 203, Tamilnadu
Objective: Assessing the patients’ response to
stress in terms of acute phase proteins maybe of
great value in determining the prognosis head
injury patients and also for providing possible new
therapeutic management protocol.
Methods: The present study was based on 103
prospectively selected patients admitted to the
male head injury intensive care unit, institute of
neurology, government general hospital Chennai.
Blood samples were drawn between 10 am and
11 am by venipuncture on admission (within first
24 hours of trauma) and on every alternate day
during the first week and once in a week during
the second and third week. The control group had
194
52 healthy volunteers .clinical outcome was
assessed based on the Glasgow outcome scale
(GOS) and the patients were classified into three
groups as group1: patients with good recovery,
group2: patients with moderate or severe disability
and group3: patients in persistent vegetative state
or death. Radial immunodiffusion (RID) assay was
used for c-reactive protein (CRP), ceruloplasmin
(CS) and transferrin estimation. Albumin was
assayed using dye binding method.
Results: The patients with head injury had a
profound acute phase response which lasted
throughout the 21 day study period. Increasing
level of CRP was noted up to fifth day, after which
Indian Journal of Clinical Biochemistry Supplement, 2009/24
it decreased slowly but still remained significantly
higher than control throughout the study period.
A similar trend was observed with CP levels in
which peak levels were recorded during the second
week. The concentration of transferin fell rapidly
after head injury and the levels remained below
normal in all the three groups throughout the three
weeks time. Using a stepwise regression analysis
a prognostic index was derived. GCS predicted
the outcome of 61.1 % of patients correctly
whereas in conjunction with T4, TCS, TRP and
CP the prognostic ability improved to 86.5 %.
Stepwise multiple discriminant analysis yielded
three prognostic indeces I, II and III for group 1, 2
and 3 respectively with a correct prediction average
of 93.2.
Conclusion: From the discriminant function
analysis it was found that acute phase reactant such
as CP and CRP may be of paramount help to
distinguish group 2 patients from others
Abstract No: 6.16
Biochemical Profile of Cord Blood in Normal Pregnancy and Pregnancy
Induced Hypertension.
Miss D.Prathima , Dr. U.B.Vijaya lakshmi and Prof. Dr. K. Ambika Devi
Dept. of Biochemistry ,ASRAM Medical college , Eluru, A.P; Email : [email protected]
Background : Pregnancy induced hypertension
(PIH) is a significany health problem and is the
leading cause of maternal and perinatal mortality
and morbidity. Low birth weight and prematurity
is common in such cases.
Objective: This study was designed to compare
certain biochemical parameters in cord blood of
children born to mothers with PIH and to mothers
with normal pregnancy.
Methods: For this purpose 10ml of cord blood
during delivery was collected from mothers
attendingobstetrics department at ASRAM
medical college,Eluru.30 samples were collected
from mothers with uncomplicated pregnancy and
50 samples from the mothers with PIH (maternal
age matched).The 50 samples include group A20 mothers with pre-eclampsia and group B-30
mothers with gestational hypertension.The
biochemical parameters measured were
glucose,urea,total
proteins,total
cholesterol,calcium & magnesium.
Results: It was observed that all the parameters
except for total cholesterol and calcium were
significantly lower(p<0.00001) in the cord blood
of babies born to mothers with PIH.The total
cholesterol and calcium were significantly higher
in the same cases (p<0.001).On comparison of
parameters of cord blood in babiesweighing >
2.5kg in cases vs controls,there was significant
decrease in all the parameters in the former.
Conclusion: So the neonates born to mothers with
PIH must be screened carefully to prevent mortality
and morbidity due to low levels of the important
biochemical parameters like glucose and
magnesium.Neonates weighing >2.5kg are also at
similar risk
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.17
Comparision of Plasma Phosphdiesterase Activity in Premenstrual and
Menstrual Period.
Rajyalakshmi M, Indu R Warrier, Dr. Krishnananda Prabhu and Dr. Anjali Rao
Department of Biochemistry, Kasturba Medical College Manipal, India-576104. E mail:
[email protected]
Background: Both menstruation and pregnancy
are inflammatory conditions that cause a degree
of physiological ischemia-reperfusion.
Contractility of uterine smooth muscle is essential
for the cyclic shedding of the endometrial lining
and also for expulsion of the fetus during
parturition. Cyclic nucleotide phosphodiesterases
(PDEs) are a diverse enzyme group with multiple
regulatory properties and wide tissue distribution.
Such activity includes cyclic adenosine (cAMP)
and guanosine monophosphate (cGMP)
breakdown. Cyclic nucleotide accumulation has
been implicated in dilatation of intact tonic spiral
arteries uterus and in relaxation of myometrium.
Isoforms of the PDE4 family are shown to be
involved in smooth muscle contraction and
inflammation. PDE4 inhibitors have been shown
to prevent inflammation-induced preterm delivery.
age 21 yrs in the premenstrual period and on first
day of menstruation. Their respective premenstrual
and menstrual levels were compared.
Results: We observed that there is a significant
increase (p <0.05) in the phosphodiesterase levels
in the menstrual period as compared to their
respective values in the premenstrual period.
Conclusion: Our results show that there is a
significant change in levels of plasma
phosphodiesterase indicating their possible role in
uterine contraction.
References:
1. Am J Obstet Gynecol. 2004 Jan;190(1):268-74
2. Biol Reprod. 2001 Mar;64(3):857-64
3. Ginekol Pol. 2000 Aug;71(8):789-93
4. BMC Pregnancy Childbirth. 2007 Jun 1;7
Suppl 1:S12
Methods: Plasma phosphodiesterase were 5. J Immunol. 2007 Jan 15;178(2):1115-21
estimated in healthy female participant students 6. BMC Pregnancy Childbirth. 2007 Jun 1;7
of Kasturba Medical College, Manipal with mean
Suppl 1:S10
Abstract No: 6.18
Serum Calcium, Phosphorus and Alkaline Phosphatase Levels in Preterm Babies.
Sarika Singh Chauhan*, B. K. Agrawal* and Rashmi Dwivedi**
*Department of Medical Biochemistry, **Department of Paediatrics, Gandhi Medical College, Bhopal.
Email address- [email protected]
Objective: Preterm is defined as a baby with a
gestation of less than 37 completed weeks.
Preterms have low serum calcium and phosphorus
levels with increased serum alkaline phosphatase
196
activity. In this study serum calcium, phosphorus
and ALP activity were measured in preterm
babies.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: The present study comprised of 75
preterm babies. Of which 25 were of 28-30 weeks,
25 were of 30-32 weeks & remaining 25 were of
34-36 weeks (Controls) of gestational age. In these
patients following investigations were done to
assay serum calcium, phosphorus levels and serum
alkaline phosphatase activity.1. Serum calcium by
OCPC method. 2. Serum phosphorus by Modified
Metol method, and 3. Serum alkaline phosphatase
by Kinetic p-NPP method.
increased (p<0.001) at 28-30 weeks as compared
to 34-36 weeks (Controls), but serum calcium &
phosphorus levels were found to be insignificantly
decreased whereas serum ALP activity were found
to be insignificantly increased at 28-30 weeks as
compared to 30-32 weeks of gestational age in
preterm babies. The correlation between serum
calcium & phosphorus were found to be positive
at all gestational ages, whereas Serum ALP is
inversely correlated with serum calcium &
phosphorus at all gestational ages. It can be
Results: Serum calcium & phosphorus levels were concluded that high serum ALP activity & low
found to be significantly decreased and Serum serum calcium & phosphorus levels are associated
ALP activity was found to be significantly with preterm babies.
Abstract No: 6.19
Study of Effect of Phototherapy on Neonatal Hyperbilirubinemia
M Vijay and M Malathi.
Department of Biochemistry, Father Muller Medical College Mangalore, Karnataka.
Email:[email protected]
Objectives 1. To study effect of phototherapy on
neonatal hyperbilirubi-naemia. 2. To compare
effect of photo-therapy on term and preterm
neonates.
Methods: The present study was conducted at
between January 2009 and may2009 in Father
Muller Medical College, Mangaore. Patient’s data
were collected from NICU phototherapy Unit of
department of paediatrics. 42 cases were identified
out of which 25 were term and 17 were preterm
babies. Phototherapy was initiated by
paediatrician according to clinical assessment, lab
results and reference charts. Mode of phototherapy
is continuous. Blood level of bilirubin; (total,
unconjugated and conjugated in mg/dl) were
analyzed by auto analyzer Olympus-AU 400.
Levels of bilirubin recorded daily in the laboratory
of department of Biochemistry. Effect of
phototherapy on neonatal unconjugated
hyperbilirubinaemia was studied. Data were
analysed by paired “t” test. The values of
significance were evaluated with ‘p ’values. The
difference were considered significant at p<0.05.
Results: Phototherapy is effective treatment for
neonatal jaundice and the mechanism-is well
defined. The therapeutic effect depends on the light
energy emitted in the effective range of
wavelengths, the distance between the lights and
the infant, and the amount of skin exposed, as well
as the rate of hemolysis and in vivo metabolism
and excretion of bilirubin. In our study
phototherapy was effective in term neonates, as
decreasing level of both total and unconjugated
bilirubin is significant when compared daily.
However phototherapy was effective in preterm
neonates, but decreasing level of both total and
unconjugated bilirubin is not significant because
preterm neonates take longer duration.
Conclusion: Jaundice is the most common clinical
symptom and sign in neonatal period, arising from
either overproduction or under secretion of
bilirubin. Almost all neonates (60% Term and 80%
Preterm) will have bilirubin greater than 5 mg/ dl
in the first week of life and about 6% of term babies
will have levels exceeding 15 mg/ dl. Due to
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
immaturity of the enzymes involved in bilirubin
conjugation. High levels of unconjugated bilirubin
are toxic to the newborn – due to its
hydrophobicity it can cross the blood-brain barrier
and cause a type of mental retardation known as
kernicterus. If bilirubin levels are judged to be too
high, then phototherapy with UV light is used to
convert it to a water soluble, non-toxic form.
Management of jaundice is directed towards
reducing the level of bilirubin and preventing CNS
toxicity. Bilirubin in the skin absorbs light energy,
which by photo-isomerization converts the toxic
native unconjugated 4Z, 15Z-bilirubin into the
unconjugated configurational isomer 4Z, 15Ebilirubin. The latter is the product of a reversible
reaction and is excreted in bile without any need
for conjugation.
Abstract No: 6.20
SMS Tube : A Novel Way of Giving Specimen Collectors 24/7 Mobile Access to Our
Specimen Requirements Database
T F Hartley1, W. Bowling, Sharon Fong, A, Gibb, K Hen, B Hitchens, Renee Twynam-Perkins, K
Wilson, J Zhang and Nicole Herbert,
1
Quality Manager, Pathology Services, Royal Hobart Hospital, Hobart, Tasmania, Australia. School
of Computing and Information Systems, University of Tasmania, Hobart, Tasmania, Australia. Email:
[email protected]
Objectives: Pathology Laboratories typically
receive many repetitive telephone calls from
Doctors, Nurses and Phlebotomists enquiring
about what tube they need to use to collect a blood
sample for various tests. In our practice these
clients do have access to an online web database
but many claim that they do not have convenient
access to a PC to use that. This project involved
the development of a mobile phone SMS based
system which we anticipate will reduce the amount
of time ‘wasted’ on handling these calls.
Method: Our existing specimen requirements
database,
currently
viewable
at
www.centrepath.dhhs.tas.gov.au has been ported
to an SMS database query server for this project.
Typically our clients interact with this system as
follows
Specimen collection staff cannot recall what tube
to use when they are just about to collect a blood
sample for cholesterol testing so they create a
198
quick SMS query message on their mobile phone
eg ‘cholesterol’
They then send this SMS message to our SMS
database server
Our system uses a unique program to query the
database and respond
‘Cholesterol : 4ml blood, red top tube, patient
should be fasting for 12 hours. Results same day.’
If the SMS text from the caller is not immediately
recognisable eg Creat then the system responds
with a few options
‘Did you mean
Serum Creatinine
Urine Creatinine
Creatinine clearance
None of the above
Respond by SMSing us the closest number from
this list’
Indian Journal of Clinical Biochemistry Supplement, 2009/24
If the SMS text query is totally unrecognisable
then, in Release 2 of the software, it will alert our
Specimen Reception staff who will then phone
back the caller.
Results: The Release 1 of the software has been
shown to be capable of handling SMS query
messages via a GSM modem. It has been able to
analyse the content of the message to find key
acronyms and has used these to search the
database. Once the acronym has been matched
then the relevant information has been compiled
and formatted to the size of a standard SMS text
message (160 characters) and this has been sent
back to the mobile number from which the request
originated.
Basic session management has been implemented
as part of Release 1. The system has opened new
sessions for each new SMS query that it has
received. If a query has been matched exactly by
the database then the system has responded with
the name of the matching test and the relevant tube
information. The session has then been closed. If
there have been multiple matches for the query,
the system has responded with a simple “Did you
mean?” and provided a list of the possible
alternatives, with the final one being “None of the
above”. When the user has chosen one of the
options, then the corresponding database entry has
been sent. The session has been kept open until
the user replies with an option. If the user has
chosen the last option, “None of the above”, then
the query and the user details have been logged,
but Pathology has not been notified in this Release
1 version. This has closed the session. Any open
sessions have been terminated after 10 minutes if
the user has not responded. Unresolved queries
have been notified via an SMS from the system to
the user.
Conclusion: The basic functionality has been
shown to be achievable and by the time of
presentation delegates to ACBICON will be able
post SMS queries from their own mobile phones
into our system in real time. In addition the various
system management reports on usage statistics will
be demonstrable
Abstract No: 6.21
Storage Stability of Glycosylated Hemoglobin in Red Blood Cells and Dried
Blood Spots
Ruby Gupta, Ramakrishnan Lakshmy, Dorairaj Prabhakaran and Kolli Srinath Reddy
Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi-29.
[email protected]
Background: Glycosylated hemoglobin (GHb)
is an indicator of long term management of plasma
glucose; therefore it is essential that the
measurement of GHb be easier, especially for
distance monitoring in health care, population
screening and clinical trials. For the purpose of
distant monitoring and research, the stability of
samples collected and their appropriate storage is
of major concern.
Objective: Keeping these points in view, we have
estimated GHb in RBCs as well as dried blood
spotted on filter paper (DBS) and compared with
Whole Blood (WB).
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: To study the effect of storage,
accounting for the lapse of time during
transportation of samples from one place to
another, GHb was estimated in RBCs and DBS
after 30 days of storage. Twenty samples were
collected from the routine collection counter.
Blood spots were prepared on Whatman filter
paper and dried at room temperature. These DBS
were then stored in zip-lock poly bags. An aliquot
of whole blood was separated for analysis of GHb.
The rest of the blood was centrifuged at 2500 rpm.
Plasma was discarded and RBCs were stored for
the estimation of GHb. Analysis was done on day
1 and day 30.
Results: The mean GHb measured in WB, RBCs
and DBS were 6.50 ±1.44 %, 6.10 ±1.44 % & 6.70
+ 1.25 % respectively. The correlation coefficient
(r) between WB & RBCs was 0.996 & between
WB and DBS it was 0.986. The mean GHb in
RBCs were 7.07 ± 1.95 % on day 1 and 7.0 ± 1.75
% on day 30 (r = 0.983). The mean values for
DBS was 7.21 ± 1.55 % on day 1 and 7.36 ± 1.42
% on day 30 (r = 0.950).
Conclusion Glycosylated Hemoglobin in RBCs
and Dried Blood Spots showed good correlation
with the values in Whole Blood and were also
stable on storage up to 1 month and therefore can
be used in population screening and clinical trials.
Abstract No: 6.22
Data Analysis of Biochemical Values in a Polyclinic and Diagnostic Centre in
Dumdum, Kolkata
Dr.Aditi Sen (Sarkar), Sanchari Halder, Anirban Ganguly, Mononjay Banerjee, Ramkrishna
Bhattacherjee and Dr. Papia Mukherjee
Dept of Pathology, Theism Ultrasound Centre, 14-B, Dumdum Road and 3A/13 B K Paul Avenue,
Kolkata 700030; Email: [email protected]
Methods: The present work involves a systematic study of blood samples sent to a NABL accredited Clinical Biochemistry Laboratory to obtain normal and abnormal percentages of various
test values. The common tests performed on these
samples are for plasma glucose, serum urea, creatinine, uric acid, cholesterol, liver function tests,
lipid profile, electrolytes and hormonal analysis.
The daily average of samples analysed is 300 and
the tests performed is 600. The instruments used
are Cobas Integra 400, Elecsys 2010, Roche 9180
ISE and Cobas 6000. The present analysis considers an annual input of 1,59,894 tests.
Results: Plasma glucose was normal for 66%,
hypoglycemia occured in 0.9% and hyperglycemia was found in 33.1% cases. Urea was normal
in 92%, high in 7.8% and low in 0.2% cases. Uric
acid was normal in 87% cases while 13% had high
200
values. Bilirubin value was normal in 97%, high
jaundice was observed in 3% of which 5% cases
were HbsAg positive. Cholesterol in 90.7% cases
was normal and 9.3% cases were high. Triglyceride was normal in 78% with 22% cases being high.
Thyroid function tests were normal in 81.2%,
hyper in 3.6% and hypo in 15.2% cases. Electrolyte imbalances were observed in 17.2% cases of
which 60% were aged above 65yrs.
Conclusion The inference is that almost 10%
cases of urea, uric acid, bilirubin and cholesterol
are abnormal; tryglycerides, thyroid function and
electrolytes were abnormal in almost 20% cases
and hyperglycemia had the highest occurrence.
Increasing tendency of these trends may be due to
stresses, pollution in the city and also lifestyle
changes caused by globalization.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.23
Evaluation of Salivary Magnesium and Protein Thiols in Children with ADHD
Archana E, Bhavya Prabhu K, Priya Pai, Dr. Krishnananda Prabhu MD, Dr. Anjali Rao, and
Dr. Revathi P. Shenoy
Department of Biochemistry, Kasturba Medical College, Manipal, India-576104.
E-mail: [email protected]
Background: Attention-deficit hyper-activity
disorder (ADHD) is the most prevalent behavioral
disorder in children and the pathophysiology
remains obscure. Ionic magnesium (Mg(2+))
depletion has long been known to cause
hyperexcitability with convulsive seizures in
rodents, effects that have been reversed by
treatment with magnesium. A positive influence
of magnesium in the prevention and treatment of
hyperactivity in children is frequently raised in
literature. The magnesium levels were found to
be moderately decreased in plasma and
erythrocytes, and the Mg2+ -ATPase activity was
also reduced in ADHD children. Oxidative stress
may be a common pathogenic mechanism
underlying many major psychiatric disorders, as
the brain has comparatively greater vulnerability
to oxidative damage.The levels of protein thiols
in the body indicate antioxidant status.
protein thiol by Ellman’s method and Magnesium
by colorimetric method.
Results: Salivary thiols showed a significant
increase in subjects (p < 0.001) as compared to
controls and magnesium showed significant
decrease in subjects (p < 0.01) as compared to
controls.
Conclusion: This result substantiates the role of
oxidative stress and magnesium in
pathophysiology of neurological disorders. Also
saliva can be an effective alternative tool for
evaluation.
References;
Magnes Res. 1997 Jun;10(2):143-8
J Am Coll Nutr. 2004 Oct;23(5):545S-548S
Int J Neuropsychopharmacol. 2008 Sep;11(6):85176
Objective: Our study was undertaken to quantify Prostaglandins Leukot Essent Fatty Acids. 2008
the salivary levels of magnesium and protein thiols Jul-Aug;79(1-2):47-53
in children with ADHD and compared with the
J Psychiatry Neurosci. 2007 Nov;32(6):435-8
age matched healthy controls.
Methods: Saliva from 9 children with ADHD as
well as 12 healthy children was investigated for
Abstract No: 6.24
Estimation of Creatinine in Sweat
Shivaraj Gowda, Prakash Desai, Avinash A K Math, Sonal Vernekar, Shruthi Kulkarni, Vinayak
Hull and Mahantesh Ilkal
Department of Biochemistry, J. N. Medical College, Belgaum – 590010;
E-mail: [email protected]
Background: Creatinine is a metabolic product constant rate by the body. Creatinine being a
of muscle metabolism and is produced at a nitrogenous compound is primarily eliminated
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
from the body by the kidney via the glomerular
filtration mechanism. Creatinine is also excreated
through sweat. There are few literatures showing
creatinine concentration in sweat. The aim of our
study was to determine creatinine concentration
in sweat in normal individuals.
and sweat creatinine was estimated by alkaline
picrate method.
Results: 0.029 mmoles/L is the mean
concentration of creatinine in sweat has been
obtained.
Methods: The procedure for the collection of Conclusion: The creatinine concentration
sweat: Arms of 10subjects were washed and full obtained in sweat in our study is consistent with
arm were wrapped with thin polythene bag. the results shown by Chien-Tsai Huang et al.
Samples were collected after 30 min of exercise
Abstract No: 6.25
Reference Range for Serum Total Alkaline Phosphatase in Healthy Individuals
Kiran Kumar B1 , Nalini Ganesan 2 and Anbazhagan M 3
1
PG Student, 2 Professor, 3 Chief Biochemist, Department of Biochemistry, Sri Ramachandra Medical
College & Research Institute, Sri Ramachandra University, Porur, Chennai - 600 116; Email address:
[email protected]
Background: Reference value is important in
establishing a scientific basis for clinical
interpretation of laboratory data. It is the result of
certain type of quantity obtained from a group of
individuals corresponding to a state of description.
Alkaline Phosphatase (EC 3.1.3.1) hydrolyses
organic phosphates at alkaline pH and the serum
Alkaline Phosphatase has diagnostic significance
in liver and bone diseases. The level of this
enzyme is influenced by the age and sex. In order
to understand the concept of reference values and
also to learn the process of establishing the
reference range, this study was undertaken.
‘informed-consent’. Two ml of random blood
sample was collected and serum was separated and
used for the enzyme assay. Serum total Alkaline
Phosphatase was assayed using commercial
(Siemens) kit. In this kit, p-nitrophenyl phosphate
was used as an artificial substrate. The results were
expressed as U/L. The statistical analysis was done
using students ‘t’ test.
Methods: Sex matched healthy subjects of
different age groups ( each consisting of 30
volunteers) required for our study were selected
from the students and staff members of our
Medical College & Hospital after getting their
Conclusion: The present study has enabled us to
understand the factors affecting the reference
value, criteria to be considered during sample
collection, analysis and the importance of reference
ranges.
Results: The Normal range obtained in this study
is as follows: Group 1 (5-20 years): 78-152 U/L,
Group 2: (21-30 years): 48 - 132 U/L, Group 3
(31-40 years): 53-117 U/L, Group 4: (41-50 years):
Objective: To determine the reference range for 44-140 U/L. Our result shows that maximum
serum total Alkaline Phosphatase in different age Alkaline Phosphatase activity is in the age group
5 - 20 years.
groups of healthy individuals.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.26
Quality Control Evaluation using Quality Indicators - Experience of a Clinical
Laboratory in Delhi
A Manocha, S Bhargava, M Kankra, S Das and LM Srivastava
Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, India
Background: Competence of clinical laboratories
has been increasing in India due to quality
management and accreditation. This is assured by
producing accurate and precise data for patient
care. Establishment of quality indicators allows
detection and quantification of problems, which
are essential for complete quality checks. Internal
Quality Control (IQC) is based on daily monitoring
of test procedures performed in the laboratory.
External Quality Assurance Scheme (EQAS)
refers to objectively checking laboratory results
through an external agency and includes inter –
laboratory comparisons. EQAS plays a
complementary role to IQC. According to ISO
15189, the laboratory is encouraged to use a third
party control material similar or identical to the
patient sample matrix.
followed. Daily QC values are documented and
%CV calculated. Control charts are maintained to
demonstrate the stability of the analytical
measuring systems. Two EQAS programs are
followed- ACBI/CMC EQAS and Randox
International Quality Assessment Scheme
(RIQAS). In the monthly ACBI/CMC EQAS
program, the laboratory’s performance is compared
with other labs and assessed by a Variance Index
Score. The three fortnightly RIQAS programs clinical chemistry, immunoassay and cardiac are
interpreted by Target Score and Standard Deviation
Index.
Conclusion: The quality indicators give credibility
to the laboratory’s performance, along with
improvement in turnaround time. They also
provide information on critical aspects of the
Methods: We use three levels of QC material- two process, identify the necessity of improvement
levels are run twice a day at appropriate intervals actions and improve overall patient safety.
in different combinations and multi-QC rules are
Abstract No: 6.27
Quality Indicators for Measuring the Process Performance of a Clinical Laboratory
Dr.R.Balambal
Sundaram Medical Foundation, Dr.Rangarajan Memorial Hospital, Chennai.
Objective: Quality Indicator is a specific
measurement of the performance of processes
used to find whether they are in control or to
identify scope for improvement. It provides a way
of measuring, monitoring and improving the
quality of care and services. It is useful to reduce
the laboratory errors and to improve the quality
in medical laboratories. The entire laboratory
processes - pre examination, examination and
post-examination processes, need to be monitored
with quality indicators.
Methods: The indicators identified for each lab
process are as follows: - Pre examination process:
Number of - Requests without proper details,
erroneous samples taken, samples rejected, TAT
not achieved, repeat samples, needle stick injury
reported, delayed transport of Urgent samples,
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
repeated training given on specific area.
Examination process: Number of - Breakdowns
of equipments, kits unavailable, repeat tests, CA
taken for IQC (Out of range situation, imprecision,
systematic error), % Error > 10 in ILC, EQAS
results >1 SD/Accuracy Score > 3. Post
Examination process: Number of - Delayed
reports, erroneous reports, complaints from
physicians & patients. The Quality indicators can
be converted into the objectives set in SMART
format (Specific, Measurable, Achievable,
Realistic and Time bound). The target to be
achieved for all the above should be ‘Nil’. Then
the achieved percentage will be 100. The actions
taken to achieve this 100% will help in the
continual improvement of the Quality management
system processes.
Conclusion: Medical testing laboratory will have
a continuous assurance of Customer satisfaction,
for providing consistent, accurate and timely test
results when the process performance is monitored
with these Quality indicators.
Abstract No: 6.28
Serum Protein Electrophoretic Pattern of Chronically ill Patients in a
Tertiary Care Hospital
Vijayasree N
Educare Institute of Dental Sciences, Malappuram, Pin 676 504 and George Abraham, Malabar
Institute of Medical Sciences, Calicut, Pin 673 016; e mail – [email protected]
Background: Protein electrophoresis is the
technique employed in major clinical laboratories
for screening abnormal proteins pattern in serum
and other biological fluids. Serum protein
electrophoresis is extensively employed for the
diagnosis and prognosis of many chronic diseases
such as myeloma, leukemia, nephrotic syndrome,
autoimmune diseases and acute phase reactions.
Objective: In the present study an attempt has
been made to evaluate the changes, if any, in the
serum protein electrophoretic pattern
Methods: Patients with chronic diseases who
were admitted in a tertiary care referral hospital
(Malabar institute of Medical Sciences, Calicut)
during the period from January to December 2006.
Patients with any chronic diseases showing
changes in their serum proteins pattern (as
assessed by the estimation of serum total proteins
by Biuret method and albumin by BCP dye
binding method) were included in the study.
204
During this period a total of eighty nine serum
samples were selected and subjected for serum
protein electrophoresis in Agarose gel (Ready to
use Hydragel Protein K (20) kit supplied by M/S
Sebia, France).
Results: Eight type of abnormal electrophoretic
patterns namely, hypergammaglobulinemia,
inflammatory disease, hypergamma globulinemia
with beta gamma bridge, monoclonal gammopathy
with M band, polyclonal gammopathy , free light
chain disease, hypogammaglobulinemia and
bisalbumi-nemia were observed. Hypergammaglobulinemia and inflammatory disease were
common constituting 48% and 27% of the total
cases respectively. The changes in the
electrophoretic pattern may be attributed to liver
diseases or autoimmune diseases. In
hypergammaglobulinemia and inflammatory
diseases the females were predominantly affected
(67% and 65% rrespectively). A seasonal variation
Indian Journal of Clinical Biochemistry Supplement, 2009/24
in the prevalence of inflammatory disease was
observed with maximum prevalence in summer.
Monoclonal gammopathy with M band and
hypergammaglobulinemia with beta gamma
bridge were seen in 4 patients each whereas
polyclonal gammopathy and freelight chain
disease were seen only in 3 cases each.
Bisalbuminemia and hypogamma-globulinemia
were very rare and could be detected only in one
case each.
Conclusion: From this study it can be concluded
that improved techniques of electrophoresis along
with software support is more useful in facilitating
the diagnosis of various diseases related to acute
phase reactions, chronic diseases and hyper/hypo
immune reactions in addition to multiple myeloma.
Abstract No: 6.29
Immunocharacterisation of Polyclonal and Monoclonal Antibodies Raised against
Cobra Venom Toxin
Lakshmi.A 1, Dr. K.S.Vasudevan2, Mr.A.Mathialagan 2 and Dr.S.Subramanian1
1Dept.of Biochemistry, University of Madras, 2 Dept.of Immunotoxicology, Mediclone Biotech Pvt.
Ltd., CHENNAI.
Objective: Snakebites continue to be a major
concern in India. The polyvalent antivenom
available possess more problem in anaphylactic
shocks. The development of monoclonal
antibodies specific for various toxins of the venom
is the only solution. In the present study, an attempt
was made to characterize the various toxic
compounds of cobra venom and to raise specific
monoclones against the characterized toxic
compounds of cobra venom.
Method: Cobra venom was characterized by Ionexchange chromatography and the protein levels
in each fraction was estimated by Lowry’s
Method. The protein was purified by SDS and
NATIVE PAGE. The hemolytic activity of the
fractions was determined by direct microtitre plate
and indirect blood agar plate methods. The
Phospholipase A2 activity of the fractions was
determined by the direct tube and the indirct plate
methods. Cytotoxicity assay was performed to
determine the cytotoxic activity of the fractions.
Invivo immunization of balb/c mice was carried
out after determination of the lethal dose for cobra
venom. Hyperimmunized status of the mice was
confirmed by Double Immuno Diffusion method.
Cell fusion for hybridoma production was
performed and the monoclones were tested for
cross reactivity by ELISA technique.
Results: Cross reactivity for cobra venom was
checked using various monoclonal antibodies and
Krait venom antibodies were also found to be
reactive with the cobra venom antigen. Each
fraction should be used for the production of
monoclonal antibodies and further evaluation of
these antibodies could be used for therapeutic
purpose. This preliminary study could be used as
basis for studies on Naja naja toxin and its
neurotoxic nature. Also, this toxin can be used to
treat painful neurological movement disorders.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.30
Development of a Novel Method to Eliminate the Negative Interference of Bilirubin
on Creatinine Assay by Jaffe’s Kinetic Method in Icteric Sera.
M.M.Goyal and A.Basak
Background: The negative interference of
bilirubin in creatinine assay by Jaffe’s kinetic
method is well documented. To remove this
interference various methods had been tried. So
far, very few methods provide solution to this
problem with limitations.
Objective: To develop a simple and economic
method to remove negative interference of
bilirubin on creatinine estimation.
Methods: Icteric sera were treated with reagent
‘X’ followed by precipitation of proteins. After
this, Creatinine was estimated by Jaffe’s kinetic
method in colourless supernatant.
Results: Our findings showed that reagent ‘X’
binds covalently bilirubin (both conjugated and
unconjugated) with serum proteins which were
precipitated out by precipitating reagent.
Creatinine was estimated and accurate values were
found out multiplying by a factor.
Conclusion: Our devised method effectively
removes bilirubin interference in creatinine
estimation. It is a simple procedure with good
repeatability and economic also.
Abstract No: 6.31
Clinical Biochemistry : The Goldmine of Challenges and How do we Face It
K. Sorte, K. Palandurkar, M.M. Goyal and A. Basak
Background: Common Clinical Biochemistry
investigations done round the clock often pose
great challenges to the Biochemists. Simple
example : in lipaemic serum no investigations can
be done. Sometimes, the procedure is
cumbersome, stability of reagents is a problem or
no method is available to estimate biomolecules
of clinical interest. Interferences of endogenous
& exogenous molecules, specially different drugs
administrated to the patients, make the situation
more complicated. Cost of the investigations by
commercial kits is high and many poor patients
can’t afford it.
interferences of bilirubin in creatinine, cholesterol,
triglyceride, uric acid estimation in icteric sera. A
very simple method of porphyria diagnosis,
detection of chyle in body fluids have been
developed. A very short procedure (1½ min.) of
plasma glucose estimation has been developed for
detection and prompt initiation of therapy of
hypoglycaemic patients as a life saving measure.
Plasma ketone bodies estimation is on the way. A
simple devise has been developed for collection
of two drops of blood by finger prick for glucose
estimation obviating venepuncture. These new
methods will be discuss.
Results: In our Clinical Biochemistry Laboratory,
we have developed few new methods to overcome
different day to day problems faced. Our team has
developed some simple methods to remove
Conclusion: Hence, future is awaiting for us with
many avenues open to solve the problems in
Clinical Biochemistry for better patients’ care as
well as to save our patients’ lives.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 6.32
Hyperhomocysteinemia and Folic Acid, Vitamin B12 Levels and their
Correlation in Eclampsia
Shahid A. Mujawar1, Vinayak W. Patil1, Rekha G. Daver2 and Narayan A. Madrasi3
1
Department of Biochemistry, Grant Medical College and Sir J.J. Group of Government Hospitals,
Byculla, Mumbai – 400008, Maharashtra, India, 2Department of obstetrics and Gynecology, Grant
Medical College and Sir J.J. Group of Government Hospitals, Byculla, Mumbai – 400008, Maharashtra,
India, 3Department of Biochemistry, Government Medical College and General Hospital, Miraj –
400008, Maharashtra, India. Email: [email protected]
Objective: An elevated level of circulating total
homocysteine (tHcy) is recognized as an
independent risk factor for cardiovascular
diseases. Moreover, determinants of
hyperhomocysteinemia, such as low
concentrations of folic acid and vitamin B12
coenzymes involved in tHcy metabolism are also
associated with increased risk of vascular damage.
Therefore, in the present study we estimate the
levels of tHcy, folic acid, and vitamin B12 and
their relationship in patients with Eclampsia.
evaluated by solid phase, competitive
chemiluminescent assay method. These parameters
were determined by means of Immulite 1000
analyzer.
Results: The statistical analysis of study group
compared with normal control group, showed
significant (p<0.001) decreases in serum folic acid,
vitamin B12 levels whereas increased
concentration of tHcy in all 50 eclamptic subject
indicate hyperhomocysteinemia. Inverse and
significant correlations found between serum tHcy
Methods: 50 pregnant women with eclampsia in and folic acid, and vitamin B12 whereas, a positive
the age group of 18 to 30 years were studied over and significant correlation was observed between
a period of January 2008 to June 2009. Serum tHcy folic acid and vitamin B12 in study group.
concentration was measured by competitive
chemiluminescent enzyme immunoassay method. Conclusion: The present study found a significant
Serum folic acid concentration was investigated association between serum folic acid, vitamin B12
by boil competitive, liquid phase, ligand labeled, levels and their deficiency indicate cardiovascular
in
eclampsia
patients
with
and protein binding chemiluminescent assay risk
method. Serum vitamin B12 concentration was hyperhomocysteinemia.
Abstract No: 7.1
The Association between Serum Alkaline Phosphatase and ABO Blood Group
E.Sruti1, Nalini Ganesan2 and Anbazhagan.M3
1. PG student, 2. Professor, 3. Chief Biochemist, Department of biochemistry, SRMC and RI, SRU,
Porur, Chennai.
Objective: Alkaline phosphates (ALP) is a
hydrolase enzyme that catalyzes hydrolysis of
organic phosphate at alkaline pH. This enzyme is
present in practically all of the tissues of the body
and occurs at particularly high levels in the
intestinal epithelium, kidney tubules, bones, liver
and placenta. Small amount of intestinal ALP may
also be present, particularly in the sera of
individuals of blood groups ‘B’ or ‘O’ (secretors).
Our objective was to estimate the amount of ALP
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
in different blood groups of healthy individuals, by using TULIP diagnostic kit. The statistical
and to compare their levels.
analysis was done using student’s t-test.
Methods: Serum levels of total ALP was detected
in 150 healthy subjects with different blood groups
in the age groups of 20 – 40 years. 2ml of random
blood sample was collected from the staff and
students of Ramachandra Medical Center after
getting their informed consent. Serum total ALP
was assayed by dimension RXL using SIEMENS
kit. In this kit. p-nitrophenylphosphate was used
as an artificial substrate and the results were
expressed in U/L. Blood groups were determined
Results: The mean value of serum ALP was higher
in ‘B’ and ‘O’ blood group individuals when
compared to ‘A’ and ‘AB’ blood group individuals,
though this did not reach statistical significance.
Conclusion: The results of the present study
indicate that there was no significant change in
the ALP level of 150 healthy individuals with
different blood groups.
Abstract No: 7.2
Guidelines and Recommendation for Laboratory Analysis in the Diagnosis
Dr. Alok Parekh, Dr.Maulik Nayak, Dr.Rita Shah and Dr. D.A. Trivedi
Content: Assessment of plasma glucose remains
the only diagnostic standard for diabetes. Patients
can monitor glycemic control by measuring their
own plasma of blood glucose with meters & by
laboratory analysis of glycated hemoglobin. The
Methods: An expert committee outlined evidence- potential roles of noninvasive glucose monitoring,
based recommendations for the use of laboratory genetic testing autoantibodies, microalbumin,
analysis in diabetes. An external panel of experts proinsulin, C-peptide, and other analytes are
reviewed guidelines & customized in response to addressed.
reviewers’ suggestions. A revised draft was
presented at the AACC Annual Meeting in July, Summary: Based on published data or derived
2000. The recommendations were modified from expert consensus, the guidelines provide
another time in response to oral and written specific recommendations. Several analytes are of
remarks & further reviewed by the Professional minimal clinical value at the present time and
Practice Committee of American Diabetes measurement of them is not recommended.
Association.
Background: The quality of scientific evidence
supporting the use of several laboratory tests varies
significantly in the diagnosis and management of
patients with diabetes mellitus.
Abstract No: 7.3
Establishing a Reference Range for Thiopurine Methyltransferase (TPMT)
Activity in Indian Populations
Jayashree T1, Sadik A Mahammad1, Ramchandra Rao O1, Rupa Banerjee2and Nageshwar Reddy D2
1
Asian Healthcare Foundation, 2Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad-500083.
Objective: Assaying the activity of thiopurine
methyltransferase (TPMT), an enzyme
metabolizing thiopurines used for treatment of
208
various inflammatory conditions, is of clinical
relevance for reducing the associated risk of acute
toxicity. While reference ranges for TPMT activity
Indian Journal of Clinical Biochemistry Supplement, 2009/24
have been established in other countries, limited
information is available in the highly
heterogeneous Indian population. The present
study was thus conducted to establish a reference
range for TPMT activity in Indian population.
Results: The histogram of combined population
study showed a bimodal distribution of TPMT
activity, with no subject having low TPMT activity
(<3 units). The range of TPMT activity was wide
(3 to 39 nmolh-1ml-1PRBC). The TPMT activity in
the females was found to be significantly less than
Methods: TPMT catalyses the conversion of 6- those of males.
mercaptopurine
(6-MP)
to
6methylmercaptopurine (6-MMP) which can be Conclusion: This is the first comprehensive TPMT
measured by HPLC. TPMT activity was assayed phenotype study from India for establishing
in red cell hemolysates obtained from 200 healthy reference range for Indian population. The cut-off
volunteers (168 males and 32 females) employing point for intermediate and low TPMT activity is
HPLC- based assay with UV detection of the usually determined by receiver operating curve
product at 290 nm. Units of enzyme activity were (ROC) analysis between genotypes and
expressed as nmoles of 6-MMP formed per ml of phenotypes. Studies are ongoing with regard to
finding genetic polymorphisms in the above
packed RBCs (PRBCs) per hour.
samples.
Abstract No: 7.4
Biochemical Impact of Lumirubin in Neonatal Hyperbilirubinemia
PS Kamble, RK Padalkar, PD Zende and VR Pandhare
PDVVPF’s Medical College, Ahmednagar, Maharashtra, India;
Email: [email protected]
Objective: In neonates and premature infants the
threat of hyperbilirubinemia is significant. The
intra-molecular cyclization of bilirubin occurs in
the presence of light to form a substance called
lumirubin (structural isomer). Lumirubin is
cleared from the serum is much more rapidly then
photoisomer as its excretion is so rapid. It is
probably quantitatively more important than the
configurational isomer for the bilirubin lowering
effect of phototherapy.
than exchange transfusion28 in achieving prolonged
reduction of bilirubin levels in infants with nonhemolytic jaundice. It is important to recognize
that the efficiency of phototherapy extends well
beyond its ability because it detoxifies bilirubin
instantaneously and continuously, regardless of the
serum bilirubin level. Phototherapy is associated
with an increased incidence of watery diarrhea,
thus increased fecal water loss. Unconjugated
bilirubin can induced intestinal secretions,
Method: Various types of fluoroscent light have suggesting that diarrhea may be a consequence of
been used for phototherapy. Broad-spectrum the high concentration of bilirubin within the
daylight, cool white, blue, monochromatic,
intestinal lumen.
“special blue” and a quartz-halide white light with
tungsten filament that has a significant output in Conclusion: The structural isomers are more
blue spectrum.
important than the configurational isomers in terms
Results: In all groups, light treatment appeared of the ability of phototherapy to lower the
to have its greatest impact in the first 24 to 48 concentration of serum bilirubin within normal
hours of therapy. Phototherapy is more effective level.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 7.5
Comparison of Cord Blood Atherogenic Index in Males and Females
Kharb S and Smiti Nanda*
Departments of Biochemistry and Obstetrics and Gynaecology* Pt BDS PGIMS, Rohtak, India; Email:
[email protected]
Objective: Pathological processes for
cardiovascular disease (CVD) and its risk factors
have been rooted in childhood. Changes in
maternal lipid metabolism during gestation control
availability of lipid metabolites to be fetus.
Abnormal lipoprotein profiles in childhood persist
into adult life and gender-related factors might
influence lipid levels.
Methods: The present study was planned in two
hundred women: study group consisted of 100 pre
eclamptic women and their newborns; and
hundred healthy pregnant women and their
newborns served as controls. Maternal venous
blood sample and cord blood from newborn were
collected and were analyzed for lipid profile (total
cholesterol, triglycerides, HDL cholesterol, VLDL
cholesterol, and LDL cholesterol), apolipoproteins:
ApoA-I, ApoB. Atherogenic index (A.I.) was
calculated as ratio of Apo-B to ApoA-I.
Conclusion:The results in terms of maternal and
cord blood atherogenic index and comparison
between two groups and influence of genderrelated factors on lipid profile will be discussed.
Abstract No: 7.6
Quality Control in Clinical Chemistry: Minimal Requirements for an Acceptable
Program
Dr. Manju Bala Pahwa* and Dr. Veena Singh
Department of Biochemistry, Pt. B.D. Sharma, University of Health Sciences, Rohtak-124001, [India]
Background: A properly functioning quality
control program is one of the most effective
safeguards available to ensure good quality of
laboratory work, particularly in clinical chemistry.
No longer is it sufficient to feel that laboratory
results are satisfactory. It is rapidly becoming
necessary to know that they are satisfactory and
to have tangible evidence of competence. Quality
control measures provide that knowledge and
evidence.
Objective: The main objective of quality control
210
is to ensure good overall performance and thus
greatly to enhance the confidence that can be
accorded to any single estimation. Quality control
programs stress accuracy at the bench level.
Conclusion: This approach in itself is
praiseworthy, for if the estimation is in error, the
whole report is in error. Since each laboratory has
its own problems, variations in quality control
programs can be expected. Components of a
minimal program of quality control in clinical
chemistry will be discussed.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 7.7
Quality Indicators: A Tool for Continuous Quality Improvement in Clinical
Laboratories
S.Subramaniam and Shyama Subramaniam
Department of Biochemistry, Apollo Hospitals, Chennai – 600 006.
Background: Quality indicators (QI) are defined
as specially identified measurable elements for a
laboratory performance giving a base for evalution
and improvement of the laboratory quality.
control results, external quality assurance results,
imprecision, inaccuracy, total error and for
postanalytical phase number of tests not
completed, reports with wrong patient data,
average time for critical results, reporting number
of critical results successfully reported, reports
exceeding TAT, customer satisfaction, number of
reports corrected or withdrawn, LIS downtime
episodes, technical errors, etc.
Methods:The QI should measure the laboratory
performance in the key function related to patient
care and satisfaction and are usually selected as
parts of the total testing process such as
preanalytical, analytical and postanalytical phase
Conclusion:The establishment of indicators may
of laboratory activities.
allow us to detect and quantify problems in the
Results: QI for preanalytical phase may include clinical laboratory. Follow up of these indicators
error in patient identification, erroneous request, will make it possible to determine whether
test order appropriateness, inadequate sample improvement measures results in fewer error and
missing sample, needle stick injuries, etc. For higher quality.
analytical phase, QI may include internal quality
Abstract No: 7.8
Serum Sodium and Potassium Level in Emesis Gravidarum
Sana Hasan*, Dr. B.K.Agarwal* and Dr. Neelkamal Kapoor**
*Dept. of Medical Biochemistry **Dept. of Pathology, Gandhi Medical College, Bhopal. Email:[email protected] , [email protected]
Background: Emesis Gravidarum , or pregnancy
sickness is a condition effecting more than half of
all pregnant women. Extreme cases includes
dehydration, weight loss, acidosis, hypokalemia
and hyponatremia.
Methods:The study includes 30 controls of
normal pregnancy in first trimester and 30 cases
of Emesis Gravidarum also in first trimester
among the age group 18-30 years of age. 2 ml of
blood is withdrawn under aseptic precautions to
determine Serum Sodium and Potassium level by
Carelyte Electrolyte Analyzer.
Results: Highly significant decrease in K+ level
(p<0.001) was found with significant decrease in
Na+ level (p<0.01) as compared to control group
where Na+ and K+ level were found to be in
reference range.
Conclusion: The present study concluded that
Emesis Gravidarum is a significant problem in
nearly 60% of all pregnant women. Low levels of
K+ and Na+ is associated with Emesis Gravidarum
in pregnancy.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 7.9
Study of Serum Fluoride and Sialic Acid Levels in Osteosarcoma
Sandhu R, Lal H, Kundu ZS* and Sandeep, Kharb S
Department of Biochemistry and Orthopaedics*, Pt B D Sharma University of Health sciences; Email:
[email protected]
Background: Osteosarcoma is a rare malignant
bone tumor most commonly occurring in children
and young adults presenting with painful swelling.
Status of fluoride levels in serum of osteosarcoma
is still not clear. Recent reports have indicated that
there is a link between fluoride exposure and
osteosarcoma.
Glycoproteins
and
glycosaminoglycans are integral part of bone and
prolonged exposure to fluoride for long duration
has been shown to cause degradation of collagen
and ground substance in bones
Methods: The present study was planned to
analyse serum fluoride, sialic acid, calcium,
phosphorus, and alkaline phosphatase levels in
twenty five patients of osteosarcoma and age- and
sex-matched subjects with bone forming tumours
other than osteosarcoma and musculo-skeletal
pain (controls, 25 each).
Results:Mean serum fluoride concen-tration was
found to be significantly higher in patients with
osteosarcoma as compared to the other two groups.
The mean value of fluoride in patients with other
bone forming tumours were though approximately
50% of the group of osteosarcoma, however was
significantly higher when compared with patients
of group I. Serum sialic acid concentration was
found to be significantly raised in patients with
osteosarcoma as well as in the group with other
bone forming tumours as compared to the group
of controls.
Conclusion: There was however, no significant
difference in the group of patients of osteosarcoma
when compared with group of patients with other
bone forming tumours. These results showing
higher level of fluoride, sialic acid and calcium in
patients with osteosarcoma compared to others
suggesting a role of fluoride in the disease.
Abstract No: 7.10
Prevalence of Diabetes Mellitus in Urban Region of Chennai City- a part of PurseHIS study
Satyajeet Giri1, S.Thanikachalam2 and K.Sowmya3
1.Senior Research fellow 2. Professor, Department of Cardiology, 3. Assistant Professor, Department
of Biochemistry, SRMC and RI, SRU, Porur, Chennai Email: [email protected] or
[email protected]
Objectives: Endovascular disease is more
common in the south Asian region, especially in
India. Cardiovascular disease is the leading cause
of death in India and its contribution to mortality
is rising. Hence, the concept of the study is to
identify the various risk factors for Endovascular
disease affecting Cardiovascular, Peripheral
vascular and Cerebro vascular system.
212
Methods: A total of 2226 subjects from the urban
Chennai were enrolled for this study. Clinical
history, foods habits, physical activity and socioeconomic status were collected. Excluding known
diabetics all other subjects underwent OGTT and
were categorized as normal glucose tolerance,
newly diagnosed diabetics and pre diabetics based
on ADA guidelines. HbA1C was also estimated
Indian Journal of Clinical Biochemistry Supplement, 2009/24
for all the subjects and values upto 6 % was HbA1C is 14.3%, 87.8%, and 42.6% in NGT,
considered to be normal.
Diabetics and Pre diabetics respectively.
Results: Out of 2226 subjects, 1275 were found
to have normal glucose tolerance (NGT), 392 were
already diabetic (18%), 165 were newly diagnosed
diabetic (7%), 191 and 203 were respectively IFG
and IGT (9%). The percentage of abnormality in
Conclusion: The prevalence of Diabetes Mellitus
in the selected population is alarming (25%).
Hence urgent attention is required for its
prevention.
Abstract No: 7.11
A Study of Serum Ferritin Levels in Type -2 Diabetic Patients
Shiv Ram Krishn and Ekta Agarwal . Email Id: [email protected]
Objective: The objective of the study is to
compare serum ferritin levels of diabetic patients
with the control group and to study the effect of
body iron stores on diabetic complications.
concentration was 104.0 ng/ml in patients
suffering from diabetes. A directly proportional
relationship was found between serum ferritin and
blood sugar levels. The correlation was found to
be significant.(P=0.006). Diabetics with increased
serum ferritin levels have significantly poor
glycemic control which was reflected by higher
levels of GHb. Similarly, significant relationship
is evident between increased serum ferritn levels
and neuropathy, nephropathy, retinopathy and
hypertension ,whereas no significant relationship
was found between increased serum ferritn levels
and Ischaemic Heart disease(P=NS).
Methods: The study was done on 50 obese type2 diabetic patients. They were compared with an
equal number of age, sex, BMI matched controls,
selected randomly to find out the correlation
between serum ferritn and blood sugar levels. The
patients were tested for the following parameters:
Serum Ferritin, Fasting Blood sugar, postprandial
blood sugar, random blood sugar, lipid profile &
GHb using standard methods. Patients were also
evaluated for Diabetic Retinopathy, Nephropathy Conclusion: It can be interpreted from the study
that elevated iron stores reflected in elevated serum
, Coronary Artery disease and Neuropathy.
ferritin, may induce baseline metabolic
Results: Mean ferritin concentration was 70.0 ng/ abnormalities resulting in diabetes mellitus.
ml in the control group,whereas mean ferritin
Abstract No: 7.12
Comparison of Serum and Plasma Uric Acid
Dr. Shivraj Gowda, Dr. P.B. Desai, Shruti Kulkarni, Sonal Vernekar, Avinash A.K.Math, Vinayak
Hull and Mahantesh Ilkal
Department of Biochemistry, J. N. Medical College. Belgaum – 590010. Email- shru_kul @yahoo.co.in
Background: Uric acid is an organic compound
of carbon, nitrogen, oxygen and hydrogen with
the formula C 5H4N4O 3. In human blood, the
normal uric acid concentration is 3.6 mg/dL to 8.3
mg/dL. An attempt was made to find out the
difference in the values between serum and plasma
in humans by using phosphotungstate method of
Henry et al. It is a colorimetric method based on
the reduction of phosphotungstate by urate in
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
carbonate buffer at pH 10.2. It is non-specific but Conclusion: Review of literature have shown that
widely used method in all laboratories.
some laboratories are switching to plasma because
serum specimens have several inherent problems:
Methods: A pilot study was carried out taking 15 (a) an increase in turnaround time because of the
serum samples sent to biochemistry laboratory and time necessary for clot formation, especially in
same individual plasma was collected from patients receiving anticoagulant therapy; and (b)
pathology laboratory of our hospital and uric acid the risk of fibrin clot interference on automated
was estimated by phosphotungstate method of analyzers, especially those with a common sample
Henry et al.
probe and no clot detection ability. Hence an
Results: There was negligible difference between attempt was made to see the difference using
conventional method.
plasma and serum uric acid levels.
Abstract No: 7.13
Tourniquet: Lacunae of Preanalytics
Smita S. Sonoli, and Anuradha B. Patil
Department of Biochemistry, J.N. Medical College, Belgaum-590010
Objective: This study was aimed to investigate
the influence of prolonged stasis, created during
blood sample collection, on five common
biochemical parameters.
Method: Five blood samples were collected by
venepuncture from 20 healthy individuals. One
before applying standard pressure and four after
applying standardized pressure of 60 mm of Hg(1
and 3 minutes) and 90 mm of Hg (1 and 3 minutes)
with help of sphygmomanometer. Glucose, Total
protein, Albumin, Urea, Creatinine were estimated
by kit method and analysed on semiautoanalyzer
manufactured by Transasia in collaboration with
Erba diagnostics (Germany).
Results: With increase in pressure and time there
was increase in the levels of total protein and
albumin and decrease in levels of glucose and urea
(p <0.05). However creatinine did not show change
in values on short term stasis, but prolonged stasis
(90 mm of Hg for 3 minutes) showed decrease in
values (p < 0.02).
Conclusion: From our results, we conclude that
the parameters in question are influenced by the
duration and magnitude of pressure applied, hence
tourniquet should be used meticulously.
Phlebotomists should be educated regarding the
usage of tourniquet so that we can identify and
prevent laboratory errors.
Abstract No: 7.14
Simplified Procedure for Cholesterol Determination
Dr. Shivraj Gowda, Dr. P.B. Desai, Sonal N. Vernekar, Vinayak Hull, Avinash A.K.Math, Shruti
Kulkarni and Mahantesh Ilkal
Department of Biochemistry, J. N. Medical College. Belgaum – 590010, Email: [email protected]
Background: Cholesterol is a sterol that is found
in all animal tissues and serves many important
214
physiological functions. High blood cholesterol
has been associated with heart disease. Hence total
Indian Journal of Clinical Biochemistry Supplement, 2009/24
cholesterol estimation is used to diagnose and
monitor the disease. Liebermann described the
colour reaction of sulphuric acid with the solution
of cholesterol in acetic anhydride. Burchard
reported that more intense blue-green colour is
produced when acetic acid and sulphuric acid are
to be added to the solution of cholesterol in
chloroform. Since time Liebermann-Burchard
reaction has been widely used in colorimeteric
reaction for estimation of cholesterol in biological
fluids. By using the same principle, an attempt
was made to simplify the procedure.
sodium sulphate and Reagent B without anhydrous
sodium sulphate. A Cholesterol standard graph was
prepared for both reagents and test samples were
extrapolated and compared with Autoanalyzer.
Results: In case of Reagent A, turbidity was
observed and took 20 minutes to attain clear
mixture. In case of Reagent B, turbidity was
cleared off within 10 minutes and remained stable
till 40 minutes.
Conclusion: The above method for preparation of
Reagent B provides a simple procedure in reducing
Methods: Modified reagents were prepared along the turbidity and also maintaining the colour
with routine reagents. Reagent A with anhydrous stability.
Abstract No: 7.15
Study of Lipid Profile and Glycosylated Hemoglobin (HbA1 C) in Patients of
Diabetes Mellitus
Tripti Saxena*, B.K. Agrawal*, and V.K. Sharma,**
*Dept. of Biochemistry, **Dept. of Medicine, Gandhi Medical College Bhopal.
[email protected]
Background: Diabetes mellitus is chronic
metabolic disorder, with an absolute or relative
insulin deficiency, fasting hyperglycemia,
glycosuria leading to development of
atherosclerosis, microangiopathy, nephropathy
and neuropathy. It is increasingly believed that
strict glycemic control in diabetes prevents the
progress of late vascular or neurological
complications, therefore proper assessment of
glycaemic control becomes an essential part of
monitoring.
MethodsPresent study comprised 100 patients of
DM ,.(including both type 1 and 2). Fasting blood
sample were taking and following investigations
were done:-
Blood glucose.
Total CHO CHOD-PAD method by Allainet et al.
TG GPO-POD method by Werner method.
HDL by Burnstein et al.
LDL by Friedwald’s and Fredrickson’s formula.
Glcosylated hemoglobin by cation exchange resin
method.
Results Patients have been devided in to good,
fare and poor control groups on the basis of
glycoselated hemoglobin (group 1 HbA1 C-6-8
gm%, group 2 HbA1 C 8-10%, group 3 HbA1
C>10gm% ) and found that total cholesterol
content(>200mg%),
LDL(>100mg%),
Triglycerids(>150mg%) were significantly high in
group 3(p<0.05) in comparison to group 1 and 2.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 7.16
Use of Tris-Borate Buffer in Agarose Gel Electrophoresis of Serum Proteins
Mahesh S1, Naureen Anwar1, Yeshoda K1, Saifa Yasmin1 and Dr. Nalini K1
1
Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka-576104; E-mail for
correspondence: [email protected]
Objective: Agarose gel electrophoresis of serum
proteins is a simple technique which provides
wealth of information in diagnosis of many
clinical conditions. Barbitone buffer has
traditionally been used in this technique and has
been shown to give proper separation of
components. But difficulty in access to
barbiturates has necessitated the need of an
alternative buffer. Some previous works have
used tris-borate in SDS PAGE, moving boundary
and immunoelectrophoresis of serum proteins.
The present work is carried out to optimise trisborate buffer as an alternative to barbitone buffer
for use in agarose gel electrophoresis of serum
proteins.
Methods: Tris-borate buffer of strength 0.05M
and pH 8.6 is used for the electrophoretic
procedure. Electrophoresis is run for 21/2 hours at
a current of 3mA/slide. The bands are visualized
by staining with amido schwatz. Patterns in various
disorders are then compared with the patterns
obtained with barbitone buffer.
Results: Comparison of the patterns obtained by
the use of tris-borate and barbitone buffer is
presented.
Similar
numbers
of
electrophoretically distinct components are found
by the use of either buffer. Mobilities of these
components are also comparable.
Conclusion: The similarity in the electrophoretic
pattern and mobility of the components with that
of the classical pattern indicates that tris-borate
can be a suitable alternative for barbitone buffer.
Abstract No: 7.17
Use of the Laboratory in Prediction of Outcome in the High-Risk Newborn
Dr. Alok Parekh, Dr.Maulik Nayak, Dr.Rita Shah and Dr. D.A. Trivedi
This paper assesses ability to envisage survival &
neurodevelopment outcome in the newborn period.
The laboratory plays a principal role in diagnosing
some of these. For instance, prenatal & new born
screenings are important in the diagnosis of
chromosomal anomalies and inborn error of
metabolism. Abnormal bilirubin, glucose and pH
values in the newborn periods are risk factors for
death & abnormal neurodevelopment, & the degree
of abnormality conveys additional information.
Conventionally, prognosis based on individual risk
216
factors or disease states. Many newborns have
multisystem disorders, & it is only when multiple
variable are considered that result can be predicted.
Three neonatal scores that integrate multiple
variables are discussed. Methodologic intricacy in
determining outcome are reviewed and illustrated
with survival and morbidity rates of very
premature babies. The laboratory is one of many
prognostic variables. The appraisal of laboratory
services are provided is difficult but important.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 7.18
Standardization of DAM Method by Single Step
Dr. Shivraj Gowda, Dr. P.B. Desai, Vinayak Hull, Avinash A.K.Math, Shruti Kulkarni, Sonal
Vernekar and Mahantesh Ilkal.
Department of Biochemistry, J. N. Medical College. Belgaum – 590010.
Email: [email protected]
Background: Most of the laboratories use urea
nesslerisation method which was found to be
tedious involving deproteinisation and incubation
for 20 minutes. The estimation of urea by diacetyl
monoxime (DAM) method is very simple and
quick technique of analysis. The reaction between
urea and DAM was established by Fearon in 1935.
Literature have shown many modifications of this
method, by changing the acid concentration,
oxidant ions and use of 4-amino antipyrine,
glucuronate, glucuronate glucosacchric acid,
thiosemicarbazide (TSC) to stabilize the colour.
The reaction occurs between urea and DAM in
presence of strong acid reagent, ferric ion and
thiosemicarbazide (TSC) to give a pink colour and
can be measured colorimetrically. Keeping above
principle, an attempt was made to standardize
DAM method in single step.
reagent A + Stock colour reagent B), Stock urea
standard and Working urea standard were prepared.
All the stock reagents are stored in brown bottle at
room temperature and are stable for 6 months. The
colour reagent is prepared fresh at the time of
analysis by mixing distilled water, mixed acid
reagent and mixed colour reagent in the ratio1:1:1.
This is single step method. The working standards
were taken in respective test tubes, volume was
made to 1ml with distilled water, 3ml of colour
reagent was added, tubes were mixed well and kept
in boiling water bath for 15 minutes, the tubes were
cooled and the pink colour developed was
measured at 540nm.
Result: A linear graph has been obtained.
Conclusion: DAM method in single step has been
standardized
Methods: Mixed acid reagent contains Stock acid
reagent, Mixed colour reagent ( Stock colour
Abstract No: 7.19
Effect of Feeding Practices in Neonatal Hyperbilirubinemia Subjects
PD Zende, RK Padalkar, PS Kamble and VR Pandhare
PDVVPF’s Medical College, Ahmednagar, Maharashtra, India; Email: [email protected]
Objective: Jaundice is most common vexing
problem in new born period. Especially feeding
practice in premature neonates in certain mother
shows long term adverse effect of
hyperbilirubinemia. Hence present study was
undertaken to identify the long term adverse effect
of hyperbilirubinemia in premature neonates, at
different age group (37 to 40 weeks) and birth
weight (0.9 to 3.0 kg) during onset of jaundice.
Methods: A total 70 newborns of the age group 1
to 8 days were selected for study. 35 infants were
on breast feeding and rests 35 were on bottle
feeding. The serum Total and Direct Bilirubin
217
Indian Journal of Clinical Biochemistry Supplement, 2009/24
parameter studied under above heading and is
carried out by Malloy and Evelyn (1937) method.
Results: There was slight decrease in mean value
of total and indirect bilirubin with increase in
gestational age and birth weigh of neonates during
onset of jaundice and mean value of total and
indirect bilirubin found significantly increased in
breast fed neonates of certain mother compared
to bottle fed neonates.
Conclusion: The present study has identified how
certain mothers having 3- á, 20-â- pregnanediol
factor in their milk causes hyperbilirubinemia in
neonates and it is suggested that breast feeding is
to be encourage only in the absence of aggravating
factors such as high milk levels of the steroids and
nonesterified fatty acids.
Abstract No: 7.20
Novel Therapeutic Properties of Nano Silver*
Siddhartha Shrivastava, Sunil Singh and Debabrata Dash
Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005
Background: Nanotechnology has been finding
increasing applications in biology and medicine.
Nano silver has already been known to have
antibacterial property. We recently have
synthesized highly stable biocompatible
nanoparticles of silver (10-15 nm diameter) with
enhanced antibacterial effect against gram
negative organisms 1 . Nano silver equally
prevented growth of multi drug-resistant bacterial,
which can have useful clinical application. We
subsequently discovered that nanoparticles of
silver, and not of gold, have innate anti-platelet
property2. They effectively prevent integrin αIIbβ3mediated platelet responses (aggregation,
adhesion to immobilized matrix, secretion of
granule contents, intracellular calcium and F-actin
fluxes, flow cytometric evaluation of surface
epitopes and changes in tyrosine
phosphoproteome) in a concentration-dependent
manner.
Methods: When nanoparticles were intravenously
injected into different mice strains, there was dosespecific inhibition of platelet aggregation, without
any change in tail bleeding. Electron microscopy
218
shows that nano silver accumulates within platelet
granules and reduces inter-platelet proximity.
Results: Our findings further suggest that these
nanoparticles do not confer any lytic effect on
platelets and thus hold immense potential to be
promoted as anti-platelet / anti-thrombotic agent.
Equipped with dual properties (antibacterial and
antiplatelet), nano silver has unique application
potentials in situations like coronary stents, where
it can prevent bacterial infection while keeping
platelets in inhibited state.
References: 1Shrivastava, S., Bera, T., Roy, A.,
Singh, G., Ramachandrarao, P. & Dash, D. (2007)
Nanotechnology, 18: 225103 (Characterization of
enhanced antibacterial effects of novel silver
nanoparticles)
2
Shrivastava, S., Bera, T., Singh, S., Singh, G.,
Ramachandrarao, P. & Dash, D. (2009) ACS Nano,
3: 1357-1364 (Characterization of anti-platelet
properties of silver nanoparticles)
Acknowledgment: Research funded by
Department of Biotechnology, Govt. of India, and
Alexander Humboldt Foundation, Germany
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 7.21
Evaluation of Procalcitonin as a Diagnostic Marker of Sepsis
Ms. Nandini C and Dr.N.Leela Menon
Dept of Biochemistry, Amrita School of Medicine, Kochi, Kerala, INDIA.
Email: [email protected]
Background: Sepsis is a systemic response to the curve. P value < 0.05 was considered to be
infection, which causes organ failure and death in significant.
severe cases.
Results: The sensitivity of Procalcitonin, C
Objective: To evaluate the reliability of reactive protein, WBC count, Differential
procalcitonin as diagnostic marker of sepsis by leukocyte counts and culture results are 80%,
studying it’s sensitivity and specificity and 76%, 63%, 30%, 35% respectively. The specificity
comparing it with that CRP, WBC counts, DLC of Procalcitonin, C reactive protein, WBC count
and microbial culturing.
Differential leukocyte count and culture results
are 55%, 30%, 55%, 63%, 85% respectively. The
Methods: The study was carried out at Amrita median plasma PCT and CRP concentration in
Institute of Medical science and Research centre, septic and non-septic group was 1.34, 0.39 and
Kochi. 71 blood samples were collected from the 23.4, 26.9 respectively. P value > 0.05, so there is
Clinical Biochemistry lab. Procalcitonin in the no statistically significant difference between PCT
samples
were
estimated
using and CRP. The area under the ROC curve was 0.639
Immunoluminometric assay using a luminometer for PCT (95% CI, 0.488 - 0.744) compared with
(LUMAT LB 9507) and C-reactive proteins 0.556 for CRP (95% CI, 0.498 – 0.695) .p value >
estimated using Immunoturbidimetry (OLYMPUS 0.05, there was no statistically significant
AU 2700). Data regarding the WBC count, difference between the sensitivity and specificity
Differential leukocyte count and microbial of PCT and CRP.
cultures results were obtained from Hematology
and microbiology department respectively. The Conclusion: This study conclude that sensitivity
parameters were compared to find out the most and specificity of Procalcitonin in the diagnosis
reliable diagnostic marker of sepsis. The study also of sepsis similar to that of CRP but far better when
assessed PCT and CRP as markers of sepsis by compared toWBC count, Differential leukocyte
comparing their plasma concentrations in septic count and microbial culturing. But since
and non-septic group using Mann –Whitney test. Procalcitonin is an early marker, a combination of
The two markers were compared using Receiver all parameters would provide better diagnosis
Operative Curve (ROC) the respective areas under
Abstract No: 7.22
Comparison of Various Parameters with Serum Free Light Chain Assay in the
Diagnosis of Multiple Myeloma
Mrudula EV and Dr Sajitha Krishnan
Department of Biochemistry, Amrita Institute of Medical Sciences and Research Center, Kochi;
Email ID: [email protected]
Background: Multiple myeloma is the second
most prevalent blood cancer after Non-Hodgkin’s
219
Indian Journal of Clinical Biochemistry Supplement, 2009/24
lymphoma. It is characterized by excessive
numbers of abnormal plasma cells in the bone
marrow and overproduction of intact monoclonal
immunoglobulins or Bence-Jones protein (free
monoclonal ê and ë light chains).
Objective: To compare the efficiency of serum
free light chain (sFlc) assay with other biochemical
parameters in the diagnosis and prognosis of
multiple myeloma.
Method: 56 patients diagnosed with Multiple
Myeloma at Amrita Institute of Medical Sciences
were included in the study. They were grouped
into two - those with intact immunoglobulin
multiple myeloma (IIMM) and those with light
chain multiple myeloma (LCMM). Biochemical
parameters such as total protein, albumin, globulin,
creatinine were determined by photometric
method in OLYMPUS AU2700, IgG, IgA, IgM,
beta-2 microglobulin, kappa & lambda were
determined by immunoturbidimetric method in
OLYMPUS AU400. Serum protein electrophoresis
of all the patients was done by gel electrophoresis.
Results: IIMM constituted about 56% and LCMM
about 34% of the total MM patients. Among these
patients IgGκ had the highest incidence. In patients
with IIMM sFlc estimation was found to be 78%
effective and in patients with LCMM sFlc
estimation was found to be 95% effective
compared to other parameters.
Conclusion : sFlc can be used as a good diagnostic
test and can effectively replace urine test for bence
jones protein. It can also be used to monitor
patients who cannot be done by electrophoresis
and also help in rapid assessment of treatment
responses. Thus serum free light chain assay along
with other important tests can help in more efficient
diagnosis and disease management in the case of
multiple myeloma.
Abstract No: 7.23
Importance of Tacrolimus Measurement and Assessment of its Toxicity in
Monitoring Post Liver Transplant Patients
Anuja.P.S, Dr. K.N. Subhakumari and Dr. Jagathlal.P.C
Department of Biochemistry, Amrita Institute of Medical Sciences and Research Center, Kochi.
Background: Over the past 40 years, organ
transplantation has become a rapidly expanding
and important surgical specialty. After liver
transplantation, the main problems encountered
by the patients are rejection of the transplanted
organ and opportunistic infection. So
immunosuppressive drugs are given to post
transplant patients and Tacrolimus is such a drug
which is a powerful immunosuppressant. Side
effects of Tacrolimus can occur and most of these
effects are dose related. In case of Tacrolimus dose
adjustment and change in immunosuppressive
therapy can be done .So estimation of tacrolimus
will be helpful in adjusting the dose. Thus a
sufficient dose of tacrolimus can be given to
patients to prevent rejection and to minimize the
side effects.
220
Objective: Present study was carried out to show
the importance of tacrolimus assay in monitoring
post liver transplant cases and to assess the toxicity
due to Tacrolimus. Objectives of the study include
quantitative estimation of Tacrolimus
concentration in whole blood sample, estimation
of total protein, albumin, globulin, bilirubin, ALP,
ALT, AST, Creatinine, urea, uric acid, glucose,
sodium, potassium and to assess the toxicity using
the above parameters.
Methods: 20 liver transplanted patients below 50
years of age were selected from Amrita Institute
of Medical Science. Six month follow up was done
for each patient. The blood sample was assayed
for Tacrolimus by IMx analyzer using MEIA
method. The liver function tests and renal function
Indian Journal of Clinical Biochemistry Supplement, 2009/24
tests of each patient were also noted. Patients were
grouped according to their Tacrolimus
concentration. Group I (0-7 ng/ml) and Group II
(7-15 ng/ml). Then the patient groups were
compared with respect to their renal function and
liver function tests.
Results: A lower incidence of rejection was
observed. In 20 transplanted patients the incidence
of rejection was 20%. In this highest rate of
rejection was seen in group II patients with a
tacrolimus concentration 7-15 ng/ml. This study
also found nephrotoxicity and neurotoxicity in
patients even within the therapeutic range, i.e. in
group II patients. Results were compared using
Mann-Whitney test with the help of SPSS software.
Conclusion: In this study, toxicity was seen even
within therapeutic range. So it is necessary to
determine the concentration of Tacrolimus in the
blood in order to establish a dosing regimen,
maintain therapeutic levels within safe level. So
Tacrolimus assay has to be done throughout the
period of Tacrolimus intake i.e., through out the
lifetime.
Abstract No: 7.24
Six Sigma Analysis of Performance of Routine Chemistries at a Hospital Lab
Rashmi* and Dr.Narayani**
*Technologist ** Head of Lab sciences, Wockhardt Hospital and Research centre, Mumbai
Six sigma analysis of performance of chemistry
assays in a lab helps to assess the performance on
a common platform with other process parameters
in a lab.
obtained from analyzer data for each analyte.
Sigma analsis for each of 20 chemistries was
analysed using two levels of quality controls since
it is difficult to obtain samples with values at
decision limits for each analyte. We present and
Aim:Objective of the study was to evaluate discuss the data for 20 analytes run on VITROS
performance of routine chemistry assays in terms 5,1 FS chemistry analyzer.
of sigma levels calculated considering imprecision
and bias. This helps to judge quality of Conclusion: The sigma analysis showed that
performance the analyser and competence of the around 50% of analytes on the analyzer performed
operator in achieving accuracy and precision.
at five sigma or more for both levels of controls
used and 75% of analytes at or more than 5 sigma
Method:The Westgard approach was utilized for when either level of control was considered. 35
calculating sigma levels i.e. Total error – Bias/ % of analytes demonstrated target six sigma level
imprecision (CV%). Total allowable error(TE) of performance (>6 sigma) for the two levels of
includes imprecision and inaccuracy and was controls used. Corrective actions have been
obtained from CLIA limits. Bias is calculated from identified for the other chemistries performing
end of cycle report on EQAS and imprecision below the five sigma level for improvement.
Abstract No: 8.1
Hepatitis B Virus Sequence Database for Indian Isolates and Mutation Profiling Tool
Amit Tuteja1, Kaushal Madan3, Subraya K. Acharya2, Dr. K,Narayanasamy1..and Dr Swati Subodh1
1. The Centre for Genomic Applications, New Delhi, 2. All India Institute of Medical Sciences, New
Delhi 3. Institute of Liver and Billary Sciences, New Delhi. Email Address: amit[email protected]
Background: More than 350 million people in the world are chronically infected with Hepatitis
221
Indian Journal of Clinical Biochemistry Supplement, 2009/24
B virus infected population. The database contains
clinical, epidemiological, genotype and mutational
data of patients. It would also act as a Genomic
Sequence Repository for Indian isolates. Till date
database has data from 472 samples which includes
236 baseline samples as well as the follow up data
from patients who are on treatment. The database
also contains information of previously known as
well as novel mutations that have been found on
sequence analysis of clinical isolates. Few of the
mutations were also found to be associated with
the drugs that patients were administered as a part
of the treatment. At the end of the project the
Methods: As a part of an ongoing Government database would be made web accessible to public
funded project we have developed a HBV database and would also contain tools for sequence analysis
for Indian isolates which aims to be a unique and mutation detection.
resource for scientists working on HBV genetics, Conclusion:Once developed fully the Indian HBV
evolution, variability, and vaccine and drug design Database will be useful as an extensive library of
targeted to Indian population.
HBV sequences well annotated with clinical and
B Virus (HBV), and approximately 500,000 to 10,
00,000 deaths worldwide are attributed to it. India
alone has world’s second largest pool of carriers
with a prevalence rate of ~2- 4% (approx. 36
million carriers) of which 10% are highly
infectious. Wide variations in social, economic and
health factors in different regions may explain
variations in carrier rates from one part of the
country to another. HBV is reported to be
responsible for 70% of cases of chronic hepatitis
and 80% of cases of Cirrhosis of the liver.
Results: At present the database contains
annotated data mostly from North Indian hepatitis
epidemiological data.
Abstract No: 8.2
Association of Antioxidant Enzyme Gene Polymorphism in ATT Induced
Hepatotoxicity in North Indians
S.V. Rana, Sanjeev K. Sharma, R.P. Ola, S.K. Sinha, J. Kaur, and K. Singh.
Department of Super Specialty Gastroenterology, Postgraduate Institute of Medical Education and
Research, Chandigarh. 160012, India
Introduction: Drug induced hepatotoxicity in
general, is involving toxic metabolite generation
and its detoxification in the liver. Glutathione
(GSH) plays an important protective role as
intracellular free radical toxic reactive metabolites
that are generated from biotransformation of drugs
and xenobiotics. It’s plays an important role in
preventing ATT-induced hepatotoxicity.
Deficiency in GST activity, because of
homozygous null mutations at GSTM1 and
GSTT1 genes may susceptibly to ATT-induced
hepatotoxicity.
222
Aim: Therefore, the multiplex PCR was used to
determine the prevalence of deleted/addited
genotypes of both GSTM1 and GSTT1 genes in
ATT-induced hepatotoxicity patients.
Methods: In the present study, a total of 100 north
Indian adult patients of tuberculosis on ATT were
enrolled. DNA used for polymorphic analysis was
isolated from lymphocytes. The genetic
polymorphic analysis for GSTM1 and GSTT1
genes were using multiplex PCR method with âglobulin gene as positive control. The presence or
Indian Journal of Clinical Biochemistry Supplement, 2009/24
absence of GSTT1 (459 base pairs) and GSTM1
(215 base pairs) amplicons was determined in the
presence of the control â-globulin gene (268 base
pairs).
hepatotoxicity patients, 5 (31.3%) showed
GSTM1, 4 out of 16 (25.0%) GSTT1 and 7 out of
16 (43.7%) GSTT1/GSTM1/â-globulin. While13
out of 84 (15.5%) showed GSTM1, 28 out of 84
(33.3%) GSTT1, and 43 out 84 (51.2%) GSTT1/
Results: Mean age of 100 patients was 45.6 years M1/ â-globulin in non-hepatotoxicity patients.
(range 18-70 years). Out of 100 patients, 16 (16%)
were ATT-induced hepatotoxicity and 84 (84%) Conclusion: This study showed GSTM1 was
were of non-hepatotoxicity. Out of 16 significantly higher in hepatotoxicity patients as
compared to non-hepatotoxicity patients.
Abstract No: 8.3
Circulating Plasma DNA as a Diagnostic Tool – A Review
K.Ramadevi
Institute of Biochemistry, Madras Medical College, Chennai. E mail: [email protected]
Background: Free, extra-cellular nucleic acid are Method: Circulating fetal DNA molecules have
found circulating in the plasma or serum. The been detected in maternal plasma from the first
nucleic acid can be RNA, mitochondrial DNA or trimester onwards. This approach has been used
genomic DNA. The existence of extra cellular for the prenatal investigation of sex-linked
nucleic acids in the circulation was first reported diseases, fetal RhD status, and prenatal exclusion
by Mandel and Metais in 1948. However, it was of ß-thalassemia major.
only 3 decades later that further developments in
Conclusion:Analysis of circulating nucleic acids
this field have been reported, when it was
in plasma is a promising noninvasive diagnostic
demonstrated by Leon et al that cancer patients
tool, requiring only a limited blood sample. The
had much higher circulating DNA concentrations
than those suffering from non-malignant diseases. use of plasma DNA and RNA has opened up
opportunities to establish noninvasive tests for
While only small levels are detectable in health,
detecting
cancer, as tumor markers, as a predictor
higher levels are observed in disease, such as
malignancy and sepsis. Similarly the discovery of mortality and sepsis, as a prognostic marker in
of cell-free fetal DNA in maternal plasma in 1997 critically ill patients in addition to their use in
has opened up new possibilities for noninvasive prenatal detection.
prenatal diagnosis.
Abstract No: 8.4
Polymorphism of p53 Gene Codon 72 in Indian Hyperlipedimic Patients with
Cardiovascular Disease
K Ezhilarasan*, K Dhananjayan*, K.Anbarasu, A Sampath kumar**, A K Munirajan***,
Shyama Subramaniam* and S. Subramaniam*
*Department of Biochemistry, Apollo Hospitals, Chennai, **Department of Genetic Engineering,
SRM University, Chennai, ***Department of Genetics, University of Madras, Taramani, Chennai.
Objective: To study the prevalence of p53 codon Introduction: Atherosclerosis is a complex
72 polymorphism in Indian hyper lipedimic multifactorial disease involving multiple genetic
patients with cardio vascular disease.
and environmental factors. Recent studies
223
Indian Journal of Clinical Biochemistry Supplement, 2009/24
implicate the role of P53 in atherosclerotic plaque
stability by repressing vascular smooth muscle cell
proliferation signals. Key polymorphism in codon
72 of p53 contribute to the alteration of its
transactivating domain stability.
Method: Blood samples were collected from the
cardio vascular disease patients and used for lipid
profile analysis. Hyper lipedimic patients, age and
sex matched control patients were selected for the
p53 codon 72 polymorphism study.
Results: Analysis of CAD patients revealed an
significant association between the disease and the
existence of diabetes (P=0.001). Also, the CAD
patients had significantly higher level of
triglyceride (P=0.001) and cholesterol (P=0.001)
as compared to control. The p53 codon 72
polymorphism analysis on hyperlipidemic patients
shows higher percentage of Arg homozygous
genotype and lesser percentage of Arg-Pro
heterozygous genotype. None of the samples
exhibited proline homozygous genotype.
Conclusion: This study concludes that p53 codon
72 polymorphism can be used as a marker for early
diagnosis of hyperlipedimia leading to cardio
vascular disease.
Abstract No: 8.5
Silver Nanoparticles - Potential Antiplatelet / Antithrombotic Agents
Debapriya Bandyopadhyay* and B K Gupta**
*Assistant Professor, **Professor and Head, * & ** Department of Biochemistry, Subharti Medical
College, Swami Vivekanand Subharti University, Subhartipurum, N.H. 58, Delhi–Haridwar Bypass
Road, Meerut–250005 Email: [email protected]
Objective: We prospectively evaluated Silver
nanoparticles as potential antiplatelet /
antithrombotic agents.
Methods: Platelets were isolated from anticoagulated human whole blood sample from fifty
healthy donors. These platelets were suspended
in physiological buffer and each sample was
divided into four tubes, in three of them various
concentrations of prepared and characterized
Silver nanoparticles (SN) were added, fourth tube
served as control (C). Following platelet function
studies were done in all the four platelet samples:
Thrombin induced aggregation (TIA)
Integrin mediated platelet adhesion on
immobilized matrices (IPA)
Integrin mediated cell signaling and associated
cytoskeletal changes- spreading and
degranulation (ICS)
Clot retraction (CR)
Results:TIA was increasingly less marked with
increasing concentration of SN as compared with
224
C. SN showed concentration dependant Thrombin
induced Platelet Aggregation inhibition.
IPA and ICS were also increasingly less marked
with increasing concentration of SN when
compared with C. SN decreased platelet adhesion
and Integrin mediated cell signaling in a
concentration dependant manner.
Similar were the observations for CR. Increasing
concentration of SN resulted in incremental
inhibition of Clot retraction.
Conclusion: Silver nanoparticles appear to be a
potent anti-platelet agent even in low
concentrations. It has the potential for maintaining
a lower activation state for platelets, decreasing
platelet aggregation and their adhesion to Fibrin
clot. With these observations we concluded that
Silver nanoparticles are potential antiplatelet /
antithrombotic agents.
Nano Silver maybe used in therapeutics after
appropriate trials and can find a place among antiplatelet agents in use now.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.6
Rapid Detection of Mutation in RRDR of rpo B Gene for Rifampicin Resistance in
MDR-Pulmonary Tuberculosis by DNA Sequencing
Dr Surajeet Kumar Patra*,Dr Anju Jain*,Dr B L Sherwal** and Dr Ashwani Khanna ***
*Department of Biochemistry,**Department of Microbiology, Lady Hardinge Medical College &
Associated Hospital, New Delhi, India, ***Department of Chest Clinic, Lok Nayak Hospital, New
Delhi, India Email id – [email protected]
Objective: To detect the site of mutation in RRDR Results: We observed three different types of
of rpo B gene for rifampicin resistance in MDR- mutation in the RRDR of rpo B gene. The
TB by DNA sequencing.
frequency of mutation in codon 531(TCG!TTG),
526(CAC!TAC) and 516(GAC!GTC) are 60
Methods: 50 MDR-TB patients were enrolled in
%, 26.6 % and 6.6 % respectively. Of the total
our study after informed written consent.
cases studied, 6.6 % cases, although resistant to
Mycobacterial DNA was extracted from sputum
rifampicin, did not show any mutation in the
samples by Universal Sample Processing (USP)
RRDR of rpo B gene.
method and RRDR of rpo B gene was amplified
by PCR using primers RP4T and RP8T and then Conclusion: Codon 531(TCG!TTG) is the most
sequenced by automated DNA sequencing. The common site of mutation in RRDR of rpo B gene
nucleotide sequences of RRDR of rpo B gene were for rifampicin resistance in MDR-pulmonary
compared with the reference sequence.
tuberculosis followed by codon 526(CAC!TAC)
and codon 516(GAC!GTC).
Abstract No: 8.7
Apo E Genotyping from Blood Stored on Filter Paper
Rizwana Quraishi1, Ramakrishnan Lakshmy2, Ashok K Mukhopadhyay3 and Bansi L Jailkhani4
National Drug Dependence Treatment Centre1, Departments of Cardiac Biochemistry2 and Laboratory
Medicine3, All India Institute of Medical Sciences, New Delhi, India
Hamdard Medical College4, Jamia Hamdard, New Delhi, India
Objective: With increasing incidence of lipid
derangements among Asians it becomes
imperative to identify genetic markers that may
predispose individuals to coronary events. Apo E
is one of the well recognized genetic factors. In
the present study blood spotted onto filter paper
is used as a transport system to study genotyping
of Apo E gene.
fresh as well as filter spotted blood using
previously described methods.
Results: The result obtained from filter spots
showed exact match of the genotyping when
compared to fresh blood. The study was further
validated using samples collected on to filter paper
from four centers (Delhi, Hyderabad, Bangalore
and Lucknow) and stored for eight years at room
Methods: Fifty five samples were collected on to temperature. The genotyping was done
filter paper with their corresponding blood samples successfully along with the quality checking.
coming to AIIMS for lipid investigation. The filter
discs were stored at room temperature for storage Conclusion: The present study shows that dried
study. The DNA samples were extracted from the blood stored up to eight years, collected from
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
temperature conditions varying between 20 to 45
degrees centigrade with humidity upto 16 to 80
percent can be used for genotyping. Since field
conditions in developing nations are not well
equipped for performance of the test spot, this
study would help in feasible blood samples
collection and presenting their stability thus
facilitate the exchange of DNA samples among
researchers
Abstract No: 8.8
Angiotensin Converting Enzyme Gene Insertion Deletion (I/D) Polymorphism and
its Association with Microalbuminuria in Essential Hypertension
K.Ramalingam *, K.Santha †, S.Sethupathy † and R.Vinoth Kumar *
*Department of Biochemistry, Narayana Medical College and Hospital, Nellore ,A.P. † Division of
Biochemistry, Raja Muthiah Medical college and Hospital, Annamalai University, Annamalai Nagar,
TamilNadu.
Background: Essential hypertension is a known
risk factor of Cardiovascular and Reno vascular
dysfunctions. The rennin-angiotensin- aldosterone
system ( RAAS) plays a significant role in the
development of target organ damage in essential
hypertension. Micoalbuminuria has attracted
attention as an early marker of organ damage in
hypertension. Angiotensin converting enzyme
(ACE) gene I/D polymorphism is aasociated with
target organ damage in essential hypertension.
electrophoresis and results were recorded in the
Gel documentation system. The possible ACE
genotypes are D/D, I/I homozygous and I/D
heterozygous. Morning random urine samples
were collected, microalbumin and creatinine were
estimated and results are expressed in micro
albumin creatinine ratio.
Objective: The aim of the present study is to know
the distribution of ACE (I/D) polymorphism and
its relationship with microalbuminuria in essential
hypertensive patients.
Results: The distribution of D/D genotype of ACE
gene was significantly higher (38.9%) in patients
when compared to control subjects(20%)Odds
ratio 2.5 ( p <0.001) . D/D genotype is strongly
associated with microalbuminuria when compared
to I/D and I/I genotypes of essential hypertensive
patients.
Methods: 208 clinically diagnosed essential
hypertensive patients without any associated
diseases and 220 age and sex matched healthy
control subjects were included in this study. EDTA
blood was collected for the extraction of genomic
DNA and PCR was performed for analyzing
Insertion (I) and Deletion (D) polymorphism at
the 287 basepair Alu repeat sequence in the
intron16 of ACE gene followed by agarose gel
Conclusion: The results of this study suggest that
deletion (D/D) polymorphism of the ACE gene
might be an independent risk factor the
development of microalbuminuria which leads to
organ damage in essential hypertensive patient.
Therefore determination of ACE genotype may be
useful for early identification of patient at
increased risk for development of target organ
damage.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.9
Association of Antioxidant Enzyme Gene Polymorphism in ATT Induced
Hepatotoxicity in North Indians
S.V. Rana, Sanjeev K. Sharma, R.P. Ola, S.K. Sinha, J. Kaur, and K. Singh.
Department of Super Specialty Gastroenterology, Postgraduate Institute of Medical Education and
Research, Chandigarh. 160012, India
Background: Drug induced hepatotoxicity in
general, is involving toxic metabolite generation
and its detoxification in the liver. Glutathione
(GSH) plays an important protective role as
intracellular free radical toxic reactive metabolites
that are generated from biotransformation of drugs
and xenobiotics. It’s plays an important role in
preventing ATT-induced hepatotoxicity.
Deficiency in GST activity, because of
homozygous null mutations at GSTM1 and
GSTT1 genes may susceptibly to ATT-induced
hepatotoxicity.
polymorphic analysis for GSTM1 and GSTT1
genes were using multiplex PCR method with âglobulin gene as positive control. The presence or
absence of GSTT1 (459 base pairs) and GSTM1
(215 base pairs) amplicons was determined in the
presence of the control â-globulin gene (268 base
pairs).
Results: Mean age of 100 patients was 45.6 years
(range 18-70 years). Out of 100 patients, 16 (16%)
were ATT-induced hepatotoxicity and 84 (84%)
were of non-hepatotoxicity. Out of 16
hepatotoxicity patients, 5 (31.3%) showed
Objective: Therefore, the multiplex PCR was GSTM1, 4 out of 16 (25.0%) GSTT1 and 7 out of
used to determine the prevalence of deleted/ 16 (43.7%) GSTT1/ GSTM1/ â-globulin. While13
addited genotypes of both GSTM1 and GSTT1 out of 84 (15.5%) showed GSTM1, 28 out of 84
(33.3%) GSTT1, and 43 out 84 (51.2%) GSTT1/
genes in ATT-induced hepatotoxicity patients.
M1/ â-globulin in non-hepatotoxicity patients.
Methods: In the present study, a total of 100 north
Indian adult patients of tuberculosis on ATT were Conclusion: This study showed GSTM1 was
enrolled. DNA used for polymorphic analysis was significantly higher in hepatotoxicity patients as
isolated from lymphocytes. The genetic compared to non-hepatotoxicity patients.
Abstract No: 8.10
Expression of Myogenin and CD105 in Autologous Bone Marrow Derived
Mesenchymal Stromal Cells of Duchenne Muscular Dystrophy Patients.
Dr. Sumit Jhajharia*, Dr Prakash C.Mohapatra*, Debashish Das# and Sujay Singh #
* S.C.B Medical College, Cuttack, Orissa, # Imgenex India pvt ltd, Bhubaneswar. E-mail id :
[email protected]
Objective: Application of Bone marrow derived
mesenchymal stem cells represent a promising
approach for supporting new clinical concepts of
cell based therapy in regenerative medicine. The
non hematopoietic component of bone marrow
includes multipotent mesenchymal stem cells
capable of differentiating into fat, bone, muscle,
cartilage and endothelium. The present study was
undertaken to assess the expression of Myogenin
and CD105 in autologous bone marrow derived
mesenchymal stromal cells of Duchenne Muscular
Dystrophy patients.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: Five Duchenne Muscular Dystrophy
patients between 12 yrs to 24 yrs were enrolled.
With informed consent the bone marrow
mononuclear cells were harvested, cultured and
assessed for the expression of Myogenin and
CD105 using Flourescence Activated Cell Sorter
(FACS analysis).
Results: A significant increase in expression of
Myogenin and CD105 was observed in the cultured
autologous bone marrow derived Mesenchymal
stromal cells of Duchenne Muscular Dystrophy
patients. Conclusion- The expression of the above
mesenchymal stem cell markers in patients with
Duchenne Muscular Dystrophy indicate that
autologous transplantation of bone marrow derived
mesenchymal stromal cells could be of therapeutic
potential.
Abstract No: 8.11
Somatic DNA Damages in Cardiovascular Autonomic Neuropathy
Supriya Simon A1, Jayapal V2 and Dinesh Roy D3,
1
Dept. of Biochemistry, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla,
Kerala – 689 101; 2Senior Consultant Cardiologist, Govt. General Hospital, Thiruvananthapuram,
3
Genetika, Centre for Advanced Genetic Studies, Thiruvananthapuram – 695 024.
Introduction: Cardiovascular autonomic diabetic
neuropathy (CADN is one of the most clinically
significant complications of diabetes mellitus
(DM), but one of the least frequently diagnosed.
The pathophysiology range from genetic disorders
with specific gene defects to metabolic disorders
with accumulation of toxins and to autoimmune
disorders. An increased level of micronuclei has
been shown to be marker of chromosome damage.
Methods: Present study was undertaken to
quantify the extent of somatic DNA damages by
cytokinesis-block micronuclei (CBMN) assay in
subjects suffering with CADN and to asses the
various socio-economic, demographic
characteristics. Forty six subjects suffering from
autonomic neuropathy formed the study groups.
All the subjects were suffering from diabetes for
atleast 8 years and have varying degrees of
coronary artery diseases. Twenty five healthy age
and sex matched control subjects were selected.
Two to three ml of venous blood was collected
aseptically in heparinized vacuutainers and CBMN
assay was performed.
Results: The mean CBMN frequency of 15.21 of
the study subjects was significantly higher than
the CBMN frequency of 10.6 observed in the
control subjects (P<0.05). The mean CBMN
frequency in patients with CADN with respect to
various risk factors such as dyslipidemia,
hypertension, smoking, chewing, and drinking
showed increased level of somatic damage.
Conclusion: This study clearly demonstrated an
increased level of somatic damages in CADN
patients which was found to be increasing with
risk factors associated with life style and duration
of diabetes.
Abstract No: 8.12
Interaction of Iron Deficiency Anaemia and Alpha Thalassaemia in the Population
Tapash Rudra, Sila Chakrabarti and Bani Sengupta
Thalassaemia Counselling Unit, Vivekananda Institute of Medical Sciences, 99 Sarat Bose Road Kolkata 700026
Background: Anemia or hemoglobin deficiency
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in human red blood cells is one of the most
Indian Journal of Clinical Biochemistry Supplement, 2009/24
common clinical manifestations in our country,
especially in females and children.
Hemoglobinopahies and thalassemias together
with iron deficiency are the major causes, the
majority are due to iron deficiency anaemia, 1015% are due to beta globin gene defects specially
beta thalassemia. The alpha globin disorders are
less commonly reported because the diagnosis of
alpha thalassaemia is usually missed unless in the
severe homozygous form or as Hb Barts. But
presence of alpha gene has been found in cases of
unexplained anaemias.
were co-related with phenotypic changes as well
as with serum iron level.
Results: In our present study we have examined a
total of 250 samples. The cases were mostly non
tribal Bengali cases referred to our unit for
investigation of anaemia. 125 cases had iron
deficiency anaemia. In 70 selected cases of
microcytic anaemias we found two common alpha
thalassaemia mutations. We studied 55 selected
referral samples to depict the interaction between
two common alpha thalassaemia mutations with
existing iron deficiency anaemia in the
Methods: The alpha cases therefore, referred to populations.
our unit for anaemia were then subjected to
Multiplex PCR test for the common alpha Conclusions: So from the present study we can
mutations –3.7 and –4.2 deletions. The results conclude the incidence of á thalassaemia is fairly
high together with iron deficiency anaemias in the
population.
Abstract No: 8.13
Potential of Mycobacterial Excretory Secretory Protein Antigens (SEVA TB ES31, ES-43, EST-6 and ES-20) as Biomarkers to detect Mycobacterium tuberculosis
Bacilli
Anindita M1, Thamke D2, Mendiratta DK2 and Harinath BC1
Jamnalal Bajaj Tropical Disease Research Centre1 & Department of Microbiology2, Mahatma Gandhi
Institute of Medical Sciences, Sevagram – 442102, Wardha (MS). Email: [email protected] ,
[email protected], [email protected]
Objective: To study the utility of mycobacterial
ES-31, ES-43, EST-6 or ES-20 antigen as a
biomarker for differentiation of Mycobacterium
tuberculosis bacilli from nontuberculous
mycobacteria (NTM).
Results: The presence of antigen in bacilli using
FITC labelled antibody was indicated by green
fluorescence on the cell surface while its absence
by no fluorescence under microscope. In M.tb
H 37 Ra and H 37 Rv bacilli, fluorescence was
observed on addition of anti ES-31 and ES-43
antigen to mycobacterial bacilli antibody, while
no fluorescence was observed in case of EST-6
and ES-20 antigen. However all the antigens were
present in detergent soluble antigen of tubercle
bacilli. Fluorescence was not observed for ES-31,
ES-43, EST-6 and ES-20 antigen in any of the
tested NTM as well as in Escherichia coli.
Methods: Detection and location of ES-31, ES43, EST-6 and ES-20 antigens in bacilli and
detergent soluble antigen was explored using
Fluorescein isothiocyanate conjugated antibodies
against these antigens and nontubercular
mycobacterial strains were studied for the
presence of ES antigen. Detection of these
Conclusion: SEVA TB ES-31 and ES-43 may be
antigens was done from M.tb H37Ra and H37Rv used as biomarkers to distinguish M.tuberculosis
DSS antigen.
bacilli from NTM.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.14
Reliability of Pleural Fluid ADA as a Marker for Exudates
Mr.D.S.S.K.Raju, Dr.D.L.Lalitha, Dr.B.Sreehari Babu and Mr.M.Anil Kumar
Department of Biochemistry, MIMS, Nellimarla, Vizianagaram, A.P, Email ID: [email protected]
respect of ADA level in pleural fluid, a statistically
significant increase (p<0.001) was observed in
exudates (60.34U/L±35.14) as compared to pleural
fluid ADA level in transudates (14.68U/L±2.85).
The pleural fluid/serum ADA ratio is also elevated,
which is statistically significant (p<0.001) in
exudative cases when compared to transudative
cases. In the three groups of exudative pleural
Methods: In the present study 35 cases comprising effusion (tuberculosis, malignancy and
of tuberculosis, malignancy and parapneumonic parapneumonic effusion), it was observed that
effusion were included in the study as exudates in there was significant rise of pleural fluid ADA in
which 22(62%) were men and 13(48%) were tubercular effusion (97.37U/L±9.25) cases in
women. Another 25 cases of pleural effusion due comparison with cases of malignancy(30.8U/
to hypoproteinemia, liver cirrhosis, and congestive L±1.78) and parapneumonic (28.57U/
cardiac failure constituted the transudates, which L±4.39)effusions. Further a positive correlation
included 18(72%) men and 7(28%) women. In all coefficient (r=0.98) was established between the
the cases serum and pleural fluid protein as well increase of pleural fluid protein and pleural fluid
as serum and pleural fluid ADA were estimated ADA in case of tuberculosis.
by Biuret method and Gusti & Galanti method
Conclusion: In differentiating exudates and
respectively.
transudates, estimation of pleural fluid ADA and
Results: In the group of 35 patients with exudates, ratio of pleural fluid/serum ADA can be considered
pleural fluid/serum protein ratio was significantly as additional parameter of significance
higher (p<0.001) as compared to transudates. In
Background: Pleural effusion, which is a
common clinical entity, requires the identification
of the nature of effusion, either exudates or
transudates for the diagnosis of the diseases. In
comparison to transudate, it is the exudative lesion,
which needs precise diagnostic measures to find
out the cause of pleural effusion.
Abstract No: 8.15
Computational Studies of the Interactions of Some Inhibitors with HIV-1 Protease
Rajkumari Rathore, Savita Rathore, Neha Sharma and Anil Bidwai
Department of Biochemistry, Index Medical College, Indore, MP; Email: [email protected]
Background: Structure-based design has been an
integral player in molecular research for over a
decade. HIV-1 protease (HIV-1 PR) is an
important target for structure-based inhibitor
design of anti-HIV drugs. This enzyme cleaves
gag and gag-pol proteins to produce structural and
functional proteins in the virus. It has been shown
that inhibition of this process produces noninfectious virions. HIV-1 PR is a homodimer, with
230
each monomer contributing an aspartic acid to the
catalytic dyad. Two flexible flap regions cover the
ligand upon binding. Inhibitors of HIV-1 PR are
widely used in the treatment of HIV/AIDS.
However, due to the rapid development of drug
resistance of the virus and side effects encountered
upon treatment, new inhibitors of HIV-1 PR are
constantly needed.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Objective: This study was undertaken with the
objectives to understand structural features that
contribute to the interactions of ligands with HIV1 PR and to elucidate the mechanisms of these
interactions.
Methods: In this study interactions of three
potential inhibitors of HIV-1 PR, namely aha024,
xk2 and cu216, were analysed using
computational docking methods. A computational
docking program, AutoDock, was used to carry
out the simulations. AutoDock uses a Monte Carlo
simulated annealing technique for configurational
exploration with rapid energy evaluation using
grid-based molecular affinity potentials. Aha024
docked with a minimum docking energy of -19
kcal/mol, rmsd = 0.78 ú and an inhibitor constant
of 1.1x10-10 M. The respective values for xk2 were
-25 kcal/mol, 0.76 ú and 4.7x10-15 M and those for
cu216 were -15 kcal/mol, 0.59 ú and 1.5x10-8 M.
Results: Results of docking with these
peptidomimetic inhibitors show that the ligands
bind in an extended manner: the transition state
isosteres bind at the catalytic dyad and the residue
side chains occupy pockets on alternate sides of
the backbone. The amide bonds engage in a series
of hydrogen bonds with the enzyme, and also with
a conserved water molecule (H2O 301) positioned
between the flap regions and the ligand. This key
binding mode difference can provide a unique
strategy for nonpeptide inhibitor design
Abstract No: 8.16
Auto Antibody in The Cases Of Neurological Disorder
Dr.Anand Saran*,Mr.S.S.Haque*,Dr.Ashok Kumar** and Dr.Uday Kumar*
*Dept. of Biochemistry,IGIMS,Patna, ** HOD,Dept. of Neurology,IGIMS,Patna
Background: An autoantibody is an antibody (a
type of protein) manufactured by the immune
system that is directed against one or more of the
individual’s own proteins. Antibodies are normally
produced in response to a foreign protein or
typically a pathogen, which is a infectious
organism. Normally, the immune system is able
to recognize and ignore the body’s own cells.
Sometimes, however, the immune system ceases
to recognize one or more of the body’s normal
constituents as “self,” leading to production of
autoantibodies. These autoantibodies attack the
body’s own cells, tissues or organs. The causes of
autoantibody production are varied and not well
understood. It is postulated that :- 1. Due to a
genetic predisposition, 2. Environmental
trigger,such as a viral illness or a prolonged
exposure to certain toxic chemicals, 3. A hormonal
component. A diagnosis of disease can not be
made solely due to detection of Autoantibody
Methods:The diagnosis starts with a complete
medical history and a thorough physical
examination and by observing signs and
symptoms. A number of diagnostic studies is
required to identify a specific disease. Viz. 1.Blood
tests to detect inflammation, autoantibodies, and
organ involvement 2.X-rays and other imaging
scans to detect changes in bones, joints, and organs.
3.Biopsies to look for pathologic changes in tissue
specimens.
Results: Antibodies against muscle or neuronal ion
channels, and against myelin glycolipids are
clearly associated with peripheral neurological
diseases. Some of these antibodies are also being
identified in central nervous system (CNS)
disorders. In this article we present autoantibody
of significance in Neurological disorder and
various methods of its estimation.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.17
Evaluation of Serum Adenosine Deaminase Activity and Lipid Profile in Type 2Diabetes Mellitus
M.M.Suchitra 1, S.Aruna 1, K.V.N.Raju 1, K.Deepthi 1, V.Suresh 2, Aparna R.Bitla 1, and
P.V.L.N.Srinivasa Rao 1
Department of Biochemistry 1 and Department of Endocrinology 2 Sri Venkateswara Institute of
Medical Sciences, Tirupati, Andhra Pradesh, India, Email: [email protected]
Background: An altered immune status has been
found in Type 2 diabetes mellitus (T2DM).
Adenosine deaminase (ADA), has the highest
activity in T-lymphocytes, and is a well known
marker of CMI. Type 2 diabetes is associated with
systemic low-grade inflammation, and ADA
which mediates an inflammatory response is
considered an inflammatory marker. Adenosine,
the substrate for ADA enhances the effect of
insulin action on glucose transport and in the
presence of elevated ADA activity, this effect of
Adenosine is lost. Dyslipidemia commonly
observed in diabetes, is a well established
traditional risk factor for cardiovascular disease
(CVD). The present study was taken up to evaluate
serum ADA activity and lipid profile in T2DM.
Methods: 25 patients diagnosed as T2DM within
the preceding 2-3 months and 25 age and sex
matched healthy individuals were taken into the
study. Serum ADA was estimated by the method
of Galanti and Giusti using Perkin Elmer UVSpectrophotometer. Fasting blood sugar,
cholesterol, triglycerides, HDL were estimated on
Beckman Synchron CX9 autoanalyzer. VLDL and
LDL were calculated using Friedewald’s formula.
The differences in the means of the biochemical
parameters were analyzed using unpaired student’s
t test.
Results: Significant increase in serum ADA,
cholesterol, triglycerides, LDL, VLDL and a
decrease in HDL were observed in T2DM patients
when compared to controls.
Conclusion: Elevated serum ADA activity may
be an important marker of an altered immune status
even in early onset T2DM, and also indicates an
inflammatory state. Diabetic dyslipidemia
increases the risk of CVD.
Abstract No: 8.18
Immunodiagnostic Evaluation of Recombinant Filarial Antigen rWbL2.
Mahendra B.Gandhe, B.V.Sivaprasad.,Kiran Pote and M.V.R.Reddy
Mahatma Gandhi Institute of Medical Sciences,Sevagram ,Wardha-442102; Email:
[email protected]
Background: The implementation of DEC based
mass drug administration (MDA) has created need
more than in the past, for the novel filarial tests to
monitor the treated population and to assess the
transmission of infection. Recombinant filarial
antigens with higher specificity are expected to
be superior to native antigens and also help to
overcome the practical difficulty in getting suffi232
cient quantity of antigen material.
Methods: Recombinant fialarial antigen WbL2
has been identified by immunoscreening
W.bancrofti cDNA library with microfilariaemic
sera. Monospecific polyclonal antibodies were
raised against rWbL2 in BALB/c mice. Filarial
antigen and antibody assays were developed us-
Indian Journal of Clinical Biochemistry Supplement, 2009/24
ing rWbL2, antibodies raised against it and IgG
fraction of human clinical filarial serum (IgG). A
total of 90 sera samples belonging to different filarial groups were screened.
Results: Filarial antigen assays using anti rWbL2
antibodies alone or in combination with FSIgG
were 100% specific,but yielded low sensitivity of
only 40% and 60% respectively to detect
microfilariaemic cases. In contrast the filarial IgG4
antibody assay using rWbL2 antigen detected all
the 25 microfilaraemic cases screened giving 100%
sensitivity with 100% specificity. However this
assay also picked up some of the exposed / prepatent infections by detecting 16% of the endemic
normals screened.
Conclusion: Recombinant WbL2 antigen based
filarial IgG4 antibody assay provides a useful tool
to detect infected cases for the prompt initiation
of anti filarial therapy and for survelliance of elimination programme
Abstract No: 8.19
Immunomodulatory and Respiratory Burst Killing Activity of Pyrazine-2Carbohydrazide Derivatives
P.B.Miniyar1 and S. J. Makhija2,
1.Sinhgad Institute of Pharmacy, Narhe Road, Narhe, Pune-411041(M.S.), 2. S. B.College of Science,
Dept. of Biochemistry, Aurangpura, Aurangabad–431001 (M.S.),
E-mail: [email protected]
Background: Tuberculosis has been a major
health problem for developing countries including
India. Multi-Drug Resistant Tuberculosis (MDRTB) is a growing hazard to human health
worldwide and threat to control of tuberculosis.
Current estimates report the prevalence of primary
and acquired MDR-TB in India as 3.4% and 25%
respectively. In the last two decades, the AIDS
epidemic and the deadly synergy between
Mycobacterium tuberculosis and HIV have
favored the recrudescence of microbial infections
throughout the world. The current recommended
strategy for microbial infections is facing two
problems: Multi Drug Resistance (MDR) and
HIV/AIDS pandemic. Additionally, in patients
with impaired cellular immunity (HIV-syndrom),
mycobacterial and fungal (Aspergillus,
Histoplasma, etc.) infections predominate and
may coexist. Emergence of multi-resistant strains
of bacteria has increased the problem of drug
resistance dramatically. Every country in the world
has drug resistance bacteria.
Objective: The development & use of new antimicrobial agents is one of the ways to combat the
emergence of anti- microbial resistance. Synthesis
of heterocyclic compounds to explore the potential
biologically active agents still draws continued
interest. Hence the different aldehydes substituted
5-methyl pyrazine/ pyrazine-2-carbohydrazide
derivatives were prepared and tested for its
immuno modulatory and respiratory burst killing
activity.
Results : The derivatives PH 9, PH 13, PM 2, PM
5, PM 6, PM 14 have been found to be more
promising amongst the compounds tested as
compared to the –ve control.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.20
Serum Lactate – Not a Good Marker of Disease Severity in Adults With Plasmodium
Falciparum Infection
Dr Rina Triparthy* and Dr Bidyut Kumar Das**
*Associate Professor Dept of Biochemistry,SCB Medical College, Cuttack, ** Professor of Medicine,
VSS Medical College, Burla; Email-id : [email protected]
Objective: Studies indicate lactate level as an
accurate prognostic indicator and major cause
of death in children with severe malaria.This study
was undertaken to assess serum lactate levels in
various subsets of severe malaria and its
prognostic importance in adults.
Methods: Adult patients of severe malaria were
examined and classified as :
Cerebral Malaria(CM), n = 29
Non Cerebral Severe Malaria(NCSM), n = 58
Muti Organ Dysfunction(MOD) – classified as
involvement of two or more organs, n = 36
Two control groups were
Uncomplicated falciparum infection (UM), n = 64
Endemic Normals (EN), age and sex matched, n = 10
Venous blood collected was used for routine and
biochemical tests. Serum lactate was estimated
by endpoint colorimetric method.
Results: Mean control values for EN and UM were
24.4 ± 7.03 mg/dl and 37.01 ± 25.5 mg/dl
respectively. In comparison value for CM was
43.8 ± 24.3mg/dl, NCSM was 39.5 ± 28.6 mg/dl
and MOD was 58.5 ± 92.3. The values for UC
and subsets of severe malaria were significantly
high(p < 0.01) compared to EN. There was no
significant difference of lactate values between
different subsets of falciparum infection (p > 0.05)
although values were highest in MOD. The mean
lactate levels in survivors was 40.7 ± 29.2 mg/dl
compared to 87.7 ± 143.1 mg/dl in those who died
but the difference was statistically
insignificant(p<0.24). Correlation between serum
creatinine and lactate was positive (r = 0.11).
Conclusion: Serum lactate levels in adult
falciparum infection in Orissa has insignificant
prognostic value contrary to observations made in
other parts of the world.
Abstract No: 8.21
Altered Renal Profile and Liver Function Test in Case of Complicated Plasmodium
Falciparum Malaria
Shivaraj Gowda, Prakash B Desai, Sindhu J Shetty, Vijayetha S Kagwad, and Mahantesh B Ilakal
Department of Biochemistry, J. N. Medical College, Belgaum 590010, Karnataka (India); Email:
[email protected]
Background: Malaria is one of the major public
health problems in India. Around 1.5 million
confirmed cases are reported annually by the
National Vector Borne Disease Control
Programme (NVBDCP) India, of which 40–50%
is due to Plasmodium falciparum. Serious
234
complications like cerebral malaria, acute renal
failure (ARF), severe anaemia, jaundice, acidosis,
acute respiratory distress syndrome (ARDS) etc
are seen usually in association with falciparum
malaria. Severe malaria may present with non
specific clinical features making it difficult to
distinguish from other febrile illness.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
old male showed renal profile high for Serum
Creatinine 1.6 mg/dl and Blood Urea 75 mg/dl.
The electrolytes showed low Serum Sodium 133
mEq/L and normal Serum Potassium 4.6 mEq/L.
The liver profile was abnormal showing high
Serum Total Bilirubin 10 mg/dl (Conjugated 8.3
mg/dl, Unconjugated 1.7 mg/dl), Serum SGOT 138
U/L and SGPT 97 U/L. While Serum Total Protein
Results: This is a report of a 50 year old female 6 g/dl, Albumin 2.6 g/dl and A: G ratio 0.8 were
showing renal profile with elevated Serum low.
Creatinine 2.5 mg/dl and Blood Urea 111 mg/dl.
The electrolytes values showed high Serum Conclusion: P.malariae and P.falciparum are
Potassium 5.4 mEq/L and normal Serum Sodium responsible for clinically important renal disease
144mEq/L.The liver profile were abnormal the former causes chronic progressive syndrome
showing high Serum Total Bilirubin17.1 mg/dl and the latter causes acute renal disease. Jaundice
,(Conjugated 14.7 mg/dl, Unconjugated 2.4 mg/ by itself is not considered as severe malaria. When
dl) and Serum SGOT 62 U/L whereas SGPT28 serum bilirubin >3mg/dl is found in association
U/L, Alkaline Phosphatase 65 U/L were normal. with other vital organ dysfunction, which indicates
Serum Total Protein 6 g/dl, Albumin 2.4 g/dl, A:G severe disease.
ratio 0.7 were low. Whereas the report of a 20 year
Methods: We report two cases of severe malaria
who presented with non-specific clinical features.
One of the cases is a 50 year old female who was
brought to our hospital with high grade fever and
severe abdominal pain, whereas the other case was
a 20 year old male presented with high grade fever
and headache.
Abstract No: 8.22
A Study on Acute Phase Proteins and its Relationship with Hemoglobin in Anemic
Pulmonary Tuberculosis Patients
Subodh Kumar1, Kiran Saxena1, Rashmi A Kulkarni1, Avanish Mishra1, Ramesh Pradhan1 , Rosy
L. Pradhan,1 and A.R.S Sinha2
1.
Department Of Biochemistry, Sri Aurobindo Institute Of Medical Sciences, Indore (MP), 2.
Department Of Biochemistry, Peoples Medical College, Bhopal (MP)
Background: Tuberculosis (TB) remains one of
the world’s leading infectious causes of death
among adults. Every year, approximately 2 million
persons in india develop tuberculosis (TB),
accounting for one fourth of the world’s new tb
cases. Acute phase protein (APP) are a class of
diverse proteins whose blood plasma
concentration increases or decreases during the
response to inflammation, in the acute phase.
Objective:Therefore, the present study was
planned to know whether there is relationship
between serum ferritin and haptoglobin with
hemoglobin in anemic pulmonary tuberculosis
patients when compared with healthy control of
the same age group (20-58yrs) and sex.
Methods: A prospective study was carried out in
40 newly diagnosed patients with anemic
pulmonary tuberculosis at Sri Aurobindo Institute
of Medical Sciences & from the dots centre, indore.
Normal control subject (n=35) were recruited for
the study. Serum haptoglobin and ferritin levels
were estimated by ELISA method & hemoglobin
by cell counter (sysmex kx-21).
Results: The above study revealed that there is
significant increase in serum haptoglobin & ferritin
levels with decrease in hemoglobin concentrations
when compared with healthy controls. The study
suggests that ‘rise in acute phase protein causes
disturbance of iron homeostasis which leads to
anemia.’
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.23
Plasma levels of Interleukin-6 and Interleukin-10 in Rheumatoid Arthritis
Vasanthi Pallinti*, Nalini Ganesan* and Rajasekhar G#
*Department of Biochemistry, #Department of Rheumatology, Sri Ramachandra Medical College and
Research Institute, Sri Ramachandra University, Porur, Chennai – 600 116; E-mail ID:
[email protected]
Objective: To study the plasma levels of proinflammatory cytokine, interleukin-6 (IL-6) and
anti-inflammatory cytokine, interleukin-10 (IL-10)
in patients with Rheumatoid Arthritis (RA) and
healthy controls.
Methods: 120 patients diagnosed with RA
(satisfying ARA criteria) were selected for the
study. 50 healthy age and sex matched subjects
were included in the control group. PotassiumEDTA samples were analyzed for Erythrocyte
Sedimentation Rate (ESR, 1 hour) by Westergren
method and Lithium heparin plasma samples were
analyzed for Rheumatoid factor (RF), interleukin6 (IL-6) and interleukin-10 (IL-10) by ELISA
using commercial kits.
elevated (62.7 ± 27.9mm) compared to control
subjects (19.37 ± 11.4mm). The plasma IL-6 levels
were significantly elevated in RA group when
compared with control subjects (p<0.001). A
significant positive correlation was observed
between IL-6 and RF in both RA and controls. A
moderate increase in the levels of IL-10 was
observed in RA group compared to the controls.
Statistical analysis was performed using SPSS
(version 15.0) software.
Conclusion: Increased levels of IL-6 and IL-10
in the patient population clearly indicate the role
of these cytokines in the pathogenesis of the
disease. The increased ESR values and the RF
positive status in the patient group indicate active
disease condition. The correlation between IL-6
Results: 81% of the RA group was found to be and RF indicates the close association of IL-6 to
RF positive in comparison with 4% for the control disease activity in RA patients.
group. ESR values of RA group were significantly
Abstract No: 8.24
Anti - CCP Auto Antibodies in Rheumatoid Arthritis
Vinod AN*, Nalini Ganesan* and Rajasekar#
Department of Biochemistry*, Rheumatologist#, Sri Ramachandra Medical College and Research
Institute, Sri Ramachandra Medical University, Porur, Chennai. India
Background: Rheumatoid arthritis (RA) is a
chronic inflammatory arthritis with potential to
cause significant morbidity and mortality. It is
important to diagnose RA at a very early stage in
the disease. Serological tests are important in
diagnosing rheumatic diseases. To facilitate
diagnosis during the early stages of the disease a
good serological marker is needed. Besides the
rheumatoid factor (RF), another group of auto
antibodies has recently been detected in serum of
236
patients with RA. Anti – CCP antibodies are
undoubtedly among the most interesting antibodies
to have been identified in recent years. Auto
antibodies directed against citrullinated proteins
have a much higher specificity for RA. These
citrullinated proteins have been detected in the
synovium of RA patients. Citrulline is a non
standard amino acid being formed as a result of
post translational modificational change of protein
bound arginine by peptidyl arginine deaminase.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Our previous studies on the serum biochemical
marker of RA reports 56% of RF positivity in a
group of rheumatoid arthritis patients. Several
observations have indicated that anti-CCP positive
in early RA patients may develop a more erosive
disease than those without anti – CCP. In this
review we will discuss the process of formation
of citrullinated protein, its transformation to auto
antigens and the clinical utility of these auto
antibodies.
Objective: We have planned to estimate the anticcp antibodies in the RA patients (early, established
and late disease) to study our observations on the
clinical utility of this autoantibody in RA.
Abstract No: 8.25
Molecular Mechanisms Underlying the Effect of Papaya Seed Products in Regulating
Male Fertility
N. Pathak, R. M. Samartha, D. Jain, K. K. Maudar, S. Tiwari, S. Gupta. and P. K. Mishra
Bhopal Memorial Hospital & Research Centre, Raisen Bypass Road, Bhopal
Background: Fertility regulation with plant
preparation/medicaments has been mentioned in
ancient texts of indigenous system of medicine.
The major advantage of the use of herbal drugs,
being non-steroidal is that they have least side
effects, having low toxicity potential for human
use in the history of folklore medicaments and
more importantly cost effective. Plant derived
compounds or their derivatives are the basis of a
large number of established drugs. Approximately
80% of the world’s population depends on healthcare system that involved the use of traditional
medicine, medical plants, including fertility
regulating plants, are integral part of such
practices. The seed product of Carica papaya has
shown promising results in proving contraceptive
effectiveness in animal models. However,
concerted efforts at a molecular level to decipher
the mode of action of the drug have yet not been
established.
Objective: To elucidate the molecular
mechanisms of the contraceptive effects of Carica
papya seed products for developing a plant based
oral pill for male contraception.
Methods: Studies were conducted on GC-1spg
cells, a continuous mouse spermatogonial cell line
which shows characteristics of a stage between
type B spermatogonia and primary spermatocytes.
Both dose dependent and time course response
(n=3) using active compounds of Carica papaya.
The studied compounds CP-M1 & CP-M2 were
isolated from methanol sub-fraction of the benzene
column chromatographic fraction of the crude
chloroform extract of Carica Papaya Linn. Seeds
(Honey Dew Variety). Cellular DNA damage
response was studied for qualitative
phosphorylation states of ATM, ãH2AX proteins
and quantitative state of p53 phosphorylation;
measure of apoptotic index through annexin-V/PI
assay and mitochondrial depolarization; induction
of oxidative stress by CM-H2DCFDA and
formation of 8-hydroxy-2’-deoxy guanosine;
levels of anti-oxidant defense system enzyme
glutathione reductase, prior to and following
treatment were also investigated.
Results: Both the compounds exhibited an
increasing trend in DNA damage responsive
parameters in treated cells in comparison with
controls. CP-M1 & CP-M2 exposed cells showed
an increased mitochondrial depolarization and
intracellular ROS generation due to oxidative
burst, with altered antioxidant defense mechanism
finally leading to an inexorable cellular demise as
implicated by the higher apoptotic index in studied
cells.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Conclusion: Results obtained so far from the However, studies aimed at understanding signaling
preliminary studies conducted demonstrate that mechanisms involved in DNA damage, apoptosis
CP-M1 & CP-M2 compounds act by negatively and cell cycle regulation are in progress.
regulating the DNA damage signaling pathway.
Abstract No: 8.26
Prevalence of HCV Genotypes and Significance of TH1/TH2 Cytokines in Response
to Combination Therapy: A Pilot Study from Central India
P. K. Mishra, A. Bhargava, R. P. Punde, S. Tiwari, P. Vashistha, S. Varshney and K. K. Maudar
Bhopal Memorial Hospital & Research Centre, Bhopal, India
Background: HCV infection is a worldwide
public health problem and is a major cause of
hepatic fibrosis, cirrhosis, end-stage liver disease
and hepato-cellular carcinoma. Till date 6 different
HCV genotypes and more than 70 sub-types based
on the nucleic acid sequences have been identified.
Due to such high levels of genetic heterogeneity,
treatment options for HCV infections are poor. At
the moment, the only accepted antiviral therapy
with proven effectiveness is a combination therapy
of (pegylated) interferon alpha and ribavirin.
Moreover, the precise immune response against
HCV genotypes and their region specific
prevalence in central India is unknown and the
impacts of viral load, genotype, and immune
mediators on the clinical course are poorly defined.
Thus, in order to refine the current knowledge of
treatment strategies there is an ongoing need to
evaluate the influence of host and viral factors.
Aim: The objective of present study was to
perform a clinical, epidemiological and
immunological characterization of chronic
hepatitis C infection in a cohort from central India.
Methods: A total of 34 patients suffering from
chronic HCV were included in the study. Response
to combination therapy (IFN-R) was classified as
rapid virological response (RVR), defined as
undetectable HCV RNA at week 4 after the
initiation of combination therapy; early virological
response (EVR), defined as undetectable HCV
RNA at week, 5 to 12 of combination therapy;
238
and late virological response (LVR), defined as
undetectable HCV RNA after week 13 of
combination therapy. A SVR was defined as
clearance of HCV RNA (<600 IU/ml) at 6 months
after the cessation of combination therapy.
Detection of HCV RNA was done through COBAS
AMPLICOR Analyzer (minimum detection limit
600 IU/ml). Genotypic characterization of HCV
was done using Linear Array HCV genotyping test
kit from Roche Diagnostics, Mannheim, Germany.
Analysis of secreted levels of inflammatory
cytokines was performed using BDTM Multiplex
Cytometric Bead Array (CBA) Human TH1/TH2
kit from BDTM Biosciences, San Diego, USA.
Results: The prevalence of genotype 3 was found
in 91.18 % cases while 28.8% were found to be
infected with genotype 1. In genotype 3 infected
patients RVR, EVR and SVR were observed in
74.19 %, 16.12 % and 9.6 % respectively. While
in patients infected with genotype 1 RVR and LVR
was observed in 33.33 % and in 66.66 % patients.
With an intention to treat analysis 100 % and 66.6
% SVR was observed in genotype 3 and 1
respectively. However, SVR was not observed in
1 patient out of 3 in genotype 1 infected population.
A significant increase in the levels of Th1
cytokines (IL-2, TNF-á, IFN-ã) following therapy
was observed during RVR in comparison to their
base line levels (before initiation of therapy). In
addition, a week Th1 response observed in the
patients were SVR was not achieved further
Indian Journal of Clinical Biochemistry Supplement, 2009/24
indicating a strong correlation of Th1 cytokines genotype 3 is more prevalent in the central Indian
population along with traces of genotype 1. Our
with the SVR.
study also indicated that immune therapeutic
Conclusion: Given the lack of an effective response is weak in genotype 1 in comparison to
vaccine, optimal treatment of chronic HCV genotype 3. These immune responses are directly
infection is now perceived as a ‘must’. Prior related to the SVR. Besides this a better
recognition of the infecting genotype will assist understanding of these interactions will allow the
development of increasingly specific immunein scheduling the optimal treatment duration. The based interventions for prevention and treatment
present study revealed, for the first time, that of chronic HCV.
Abstract No: 8.27
Diagnosis of Mycobacterial Tuberculosis Complex (MTBC) in Endoscopic Biopsy
Samples and Paraffin-Embedded Tissue Specimens Using Real Time PCR:
Implications in Patient Care
G. V. Raghuram, A. Bhargava, R. P. Punde, S. Varshney, K. K. Maudar and P. K. Mishra
Bhopal Memorial Hospital & Research Centre, Bhopal, India
Objective: The diagnosis of Mycobacterium
tuberculosis complex (MTBC) in endoscopy
biopsy samples and formalin-fixed, paraffinembedded surgically resected tissues of the gastrointestinal tract remains a complex issue because
the most widely used conventional diagnostic
tools, such as culture and acid fast bacilli staining
are unable to rapidly detect Mycobacterium
tuberculosis with sufficient sensitivity. Using
fluorescence resonance energy transfer (FRET)
technology based on hybridization probes, we
applied a novel technique consisting of an
internally controlled quantitative real-time PCR
assay that provided a significant improvement in
detection sensitivity and quantification.
Methods: The study included three groups (A)
control (n=24) with no previous signs of MTBC,
(B) patients (n=28) with known TB origin and (C)
patients (n=50) with clinical and histopathological signs of TB but was culture and AFB
negative. The samples were obtained from
Medical & Surgical Gastroenterology
Departments of Bhopal Memorial Hospital &
Research Centre. We extracted DNA using
DNeasy Blood & Tissue kit (QIAGEN, Germany)
and performed Real time assay using Roche Light
Cycler 2.0 with FRET probes for specific
amplification of 159 bp region of mycobacterium
genome.
Results: All the samples (n=24) of group A were
found to be negative, while in group B out of total
28 cases studied 27 were found to be positive by
real-time PCR. In group C out of total 50 cases
studied 18 were found to be positive showing a
positivity of 36 %. The overall positive and
negative predictive values of the test for clinical
TB (group C) were 100 % and 96.9 % respectively.
Conclusion: Results of our investigation exhibit
that the real time detection technology using FRET
probes, has much higher sensitivity for the
detection of Mycobacterium tuberculosis complex
DNA in tissue biopsy samples and formalin-fixed
paraffin embedded surgically resected tissues of
the gastro-intestinal tract. However, to establish
the superiority of this novel technique for MTBC
diagnosis in various latent infectious states, it will
be necessary to accumulate data from a larger
number of patients with suspected tuberculosis
infection
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 8.28
Mediators of Immune System and Their Possible Role in Pathogenesis of Chronic
Hepatitis B and C Viral Infections
R. P. Punde, A. Bhargava, S. Gupta, S. Varshney, P. Vashistha, K. K. Maudar and P. K. Mishra
Bhopal Memorial Hospital & Research Centre, Bhopal, India
Background: The circulating inflammatory
biomarkers may contribute to the pathogenesis of
chronic viral hepatitis infections. The present
study was carried out in order to evaluate the levels
of circulating biomarkers in the patients with
chronic viral hepatitis of different aetiology and
their possible role in the pathogenesis of the
disease.
Methods: The study was divided into 3 groups
i.e. group 1 comprise of patients with chronic
HBV infections (n=60), group 2 included patients
with chronic HCV infections (n=60) while group
3 consist of healthy age and gender matched
controls (n=60). The mean age of all the subjects
in the study was 35 years. Total viral load was
quantified from the EDTA plasma and correlation
studies were performed with circulating Th1/Th2
cytokines; levels of C reactive protein (CRP);
glutathione reductase (GR) and superoxide
dismutase (SOD) and levels of circulating
nucleosomes.
Results: A strong positive correlation of Th2
cytokines and GR with viral load in HBV and HCV
was observed. The levels of circulating apoptotic
nucleosomes also correlated with viral load.
However, no significant correlation with CRP and
SOD was observed.
Conclusion: These results can be helpful in
designing interventional strategies like anti-viral
therapeutic and/or immunotherapeutic strategies
to prevent the progression and long term
consequence, as well as for effective prevention
of chronic infections and thereby contributing
towards developing personalized medical care
Abstract No: 8.29
Electrophoresis and Immunochemical Quantitation of Serum IgG, IgA, and IgM
in Multiple Myeloma and Study of Complications in Multiple Myeloma
Dr. Sajitha Krishnan and Toni Thomas
Department of Biochemistry, Amrita Institute of Medical Sciences, Kochi.
Background: Multiple myeloma is a chronic,
progressive and fatal malignant condition in which
the fundamental abnormality is a neoplastic
proliferation of plasma cells, which infiltrate the
bone marrow and often other body tissues. The
disease affects man kind almost universally. It
representing approximately 1% of all types of
cancer. Serum protein electrophoresis is the most
commonly used diagnostic tool for this disease.
Objective: The objective of this study was to
evaluate electrophoresis and immunochemical
240
quantification of serum IgG IgM & IgA in the
diagnosis of multiple myeloma and to study the
complication of multiple myeloma with the help
of parameters like Total protein, albumin, globulin,
A G ratio, Creatinine, Serum Alkaline Phosphatase
Serum calcium and Serum LDH.
Methods: The study was carried out at department
of biochemistry AIMS, Cochin during the period
January 2008 to January 2009. Electrophoresis was
carried out for the blood samples come with order
of serum protein electrophoresis.45 M band
Indian Journal of Clinical Biochemistry Supplement, 2009/24
positive (monoclonal protein present) blood
samples were selected and performed
immunochemical quantification of serum (IgG
IgM & IgA) ,Total protein, albumin, globulin, A
G ratio, Creatinine, Serum Alkaline Phosphatase
Serum calcium and Serum LDH.
Result: Of the 45 M band positive patients, 28
(62.22%) patients of them showed an increase in
IgG, 2(4.45%) showed an increase in IgM,
4(8.89%)patients showed elevated levels of IgA,
and 11 (24.44%) of them showed low levels of
Immunoglobulins(IgG, IgM, IgA). In the study
group, about 44% showed increased protein levels,
62% patient’s serum globulin levels were above
normal.About 42.5% patients showed low serum
albumin levels. The A/G ratio was reversed in
about 75%. 35.5% of the patients showed an
increase in serum creatinine. Among the creatinine
elevated patients, 75% of them were under IgG
type Myeloma group & about 6% were under IgA
type Myeloma and 19% of them in the Light chain
multiple myeloma group. Of the 45 patients about
33.33% of the patients have high serum ALP level.
About 60% high ALP values belonged to IgG
myeloma group, about 13.34% belonged to IgA,
and the rest 26.66% belonged to light chain
multiple myeloma group. High Serum Lactate
dehydrogenase (LDH) is seen in 57.14%
patients.Of the 57.14% LDH elevated patients,
75% high LDH values belonged to IgG myeloma
group, about 12.5%belonged to IgA,
6.25%belonged to IgM Myeloma and the 31.25%
belonged to Light chain multiple myeloma group.
Calcium levels were increased in less than 10%
patients. Among the hypercalcemic patients 50%
were in light chain myeloma.
Conclusion: Serum protein electrophoresis is not
sufficient to diagnose multiple myeloma because
the position of the band only suggests the type of
antibody. Serum protein electrophoresis alone will
be insufficient especially if the multiple myeloma
is of non-secretory type. In such cases urine protein
electrophoresis should be done to detect the light
chain produced. Immunoturbidimetric quantitative
measurement of immunoglobulin levels used along
with serum protein elcetrophoresis can be used as
a confirmatory test in the diagnosis of myeloma.
So a combination of serum protein electrophoresis
and immunoturbidometric quantitative estimation
of gammaglobulins along with clinical symptoms
can be used as tools for diagnosis of different kinds
of multiple myeloma and to classify it. In the
present study it has been noted that IgG myelomas
showed the highest prevalence rate. Moreover,
complications in myeloma were also maximum in
the IgG myeloma class. This may be due to the
greater percentage of IgG producing B-cells in the
human body. Thus these B-cells have a greater
tendency to be affected by myeloma.
Abstract No: 8.30
Comparative Evaluation of Recombinant WbSXP-1 Antigen and B.Malayi
Microfilarial Antigens in the Detection and Management of Bancroftian Filariasis
Partha Sarathi Pal, Gajalakshmi Dakshinamoorthy, Sivaprasad BV and MVR Reddy
Department of Biochemistry& JB Tropical Disease Research Centre, Mahatma Gandhi Institute of
Medical Sciences, Sevagram 442 102, Maharashtra; Email for sending acceptance:
[email protected]
Background: Immunomonitoring followed by
treatment with DEC was found to be very effective
in the management of Lymphatic filariasis
infection. Hence mass chemotherapy programs
using DEC to eliminate lymphatic filariasis
required specific, sensitive and cost effective
methods for the evaluation of infection status.
Antibody assays based on crude filarial extracts
are limited by cross-reactions with other nematode
antigens and the difficulty in getting sufficient
241
Indian Journal of Clinical Biochemistry Supplement, 2009/24
parasite material. These problems could be
overcome by replacing the native filarial antigens
with the recombinant filarial antigens.
ES & rWbSXP-1 antigens showed 92, 64 and
100% sensitivity for asymptomatic mf carriers
respectively. Further immunomonitoring of
clinical filarial cases with these assays showed that
Methods: In this study the diagnostic efficacy of the recombinant WbSXP-1 antigen based assay is
recombinant WbSXP-1 antigen and two native more sensitive and specific.
filarial antigens viz., Bm mf ´S’ & Bm mf ‘ES’
were comparatively evaluated for the detection of Conclusion: In conclusion, it can be envisaged
actively
infected
Cases
and
their that rWbSXP-1 antigen based filarial IgG4
immunomonitoring followed by DEC therapy.
antibody test will be a very useful tool in the
detection and management of Bancroftian filariasis
Results: Performance characteristics analysis of
filarial IgG4 antibody against Bm mf ´S’, Bm mf
Abstract No: 8.31
Oxidalitive Stress and Immunity Status in Leprosy
V.B.Londhe1, Sevesina P Madhale2, Z.G.Badade3, PE Jagtap4, SK Ahaley5 ..and M. M Chavan6
Asso, Prof JNMC Belgaum1 Sr. Research follow in immunolgy2 prof & Head Dept. of Biochemistry
MGMC Navi munbai3 Prof. & head Dept. of Biochemistry B.V.MC, Miraj4 , prof of Biochemistry,
BVMC Miraj5 medical superintendent TLMH. Belgaum6
Background: In many infactious and disease
Conditions people are severly affected by health
related immunity. The lymphocyte is primary cell
for immunity system. ‘T’ Lymphocytes, thymus
derived responsible for cell mediatory and ‘B’
lymphocytes from bone marrow responsible for
humoral immunity in human. Leprosy is a disease,
which strikes fear in society as a mutilating,
contagious, delaying for treatment due to fear of
rejection from family and society, horrifying
nature of physical disfigurement and no cure being
available until twenty century.
Objective: The aim of our study was to explore
the role of immunity status as upgrading disease.
Methods: In present study fifty clinically
diagnosed leprosy patients and fifty age, sex
matched healthy subjects were selected from civil
hospital Sangli, Richardson leprosy hospital Miraj
and The leprosy mission hospital, Hindalga
Belgaum. Serum Zinc estimated by AAS, Salivary
IgA estimated by Elisa, ADA activity estimated
by K. Satoh method and bacillary index decided
by ear lobe smear, Elbow smear and Tissue biopsy.
Conclusion: In our study as upgrading disease,
due to oxidative stress with increase in bacillary,
index, increases LPO and for defence mechanism
and ulilization purpose, serum Zinc, ADA and
Salivary IgA activity, which ‘T’ cell functioning
cell immunity reflect downgrading concentration
as per severity of disease. The estimations of serum
Zinc, ADA, salivary IgA and LPO as biochemical
markers for immunity in leprosy.
Abstract No: 8.32
Real Time PCR Quantitation of Minimal Residual Disease (MRD) in Acute
Lymphoblastic Leukemia (ALL).
KJ Suneetha, K Nirmala Nancy, KR Rajalekshmy, TG Sagar and T Rajkumar
Background: ALL is the most common childhood malignancy constituting about 30% of all
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
childhood cancers. Though risk adapted
chemotherapy resulted in favourable outcome in
the majority of the children, a significant
percentage of both children and adults eventually
relapse. Such failure is presumably due to residual
leukemic cells resistant to standard therapy. A
more sensitive and precise assessment of residual
leukemic cells would help tailor treatment and
improve clinical outcome of childhood ALL .
Quantitation of MRD by real time PCR allows
the detection of one leukemic cell in 104 to 106
normal cells.
identified by PCR-heteroduplex analysis, ASO
designed and MRD in followup samples
quantitated by Taqman chemistry using real time
PCR
.
Results: MRD was quantitated in 12 patients. 5/
12 are in remission and 7/12 relapsed. A maximum
detection limit of 10-5 . Ig/TCR rearrangements
were found to be reliable markers for MRD
detection and relapse prediction. We were able to
antedate molecular relapse 10-50 days before the
clinical and hematological Relapse.
Methods: 2ml of Bone Marrow and 8ml of Conclusion: Quantitation of MRD by Real time
Peripheral Blood at diagnosis and 2ml of BM at PCR ia a specific and sensitive method to antedate
different treatment intervals were collected. relapse.
Leukemia specific Ig or TCR rearrangement was
Abstract No.8.33
Role of GST Polymorphisms in the Susceptibility and Outcome in Acute
Lmphoblastic Lukemia
KJ Suneetha, K Nirmala Nancy, KR Rajalekshmy, TG Sagar and T Rajkumar
Background: ALL is the most common pediatric
malignancy constituting about 30% of childhood
cancers. The origin of this disease may be
explained by a combination of genetic and
environmental factors. The glutathione S
transferase family is involved in the metabolism
of a wide range of chemicals including
environmental carcinogens, reactive oxygen
species, and chemotherapeutic drugs.
Polymorphisms in GST enzymes have been
implicated in the susceptibility and outcome in
several cancers.
by real time allelic discrimination assay for GSTP1
polymorphisms.
Results: We found a significant increased risk for
ALL with the GSTM1 null genotype (OR: 1.96,
95%CI=1.08-3.57). Though GSTP1 by itself is not
associated with the susceptibility to ALL, when it
is combined with GSTM1, a significant increase
in risk has been observed (OR=2.78: 95%CI=1.166.69). Kaplan Meier survival analysis shows
significant inferior outcome in the patients
harbouring GSTP1 val allele (log rank p-value of
0.0025).
Methods: A total of 92 immunophenotyped ALL Conclusions: GST polymorphisms play a
patients and 150 cord blood samples(controls) significant role in the susceptibility and outcome
were analysed by PCR for GSTM1, GSTT1 and in Acute lymphoblastic leukemia.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 9.1
CSF Calcium and Magnesium (Ionic and Total) Levels: a Preliminary Study
Asharani.N***.Sindhu, Samson Sujit Kumar G*, Ramakrishna** and Ramalingam K***
Departments of Neurosurgery*, Anesthesia** & Biochemistry***, Narayana Medical College, Nellore-2, A.P
Background: There have been only few studies
to estimate the normal ionic magnesium levels in
the CSF in human beings. Role of serum ionic
magnesium has been studied in various
cardiovascular, obstetrics and neurological
disorders. Before estimating CSF ionic
magnesium levels in various neurosurgical
disorders we wanted to establish normal range of
ionic magnesium in the CSF.
Methods: Patients undergoing lumbar puncture
for anesthesia and suspected neurological
disorders were included in the preliminary study
(with ethics committee approval and patient
consent). CSF (about 0.5ml) was collected from
these patients and sent to the lab where the ionic
levels of calcium and magnesium were estimated
along with total levels. Total Ca++ and Mg++ were
measured by photometrically.The ionic Ca ++
measure by ion selective method. The ionic Mg++
measured by atomic absorption spectrophotometer.
Results: CSF was collected from 15 patients
undergoing LP for spinal anesthesia. The average
value of CSF total calcium and magnesium was
5.4mg% (2.64meq/L) and 2.7mg % (2.22meq/L).
The average ionic concentration of calcium was
1.38 meql/L for calcium and 1.96 meql/L for
magnesium. The ionic magnesium level accounts
for significant amount of total CSF magnesium.
Conclusions: Our preliminary data suggests that
ionic magnesium and ionic calcium contribute to
significant proportion of total CSF values.
Abstract No: 9.2
Serotonin, Dopamine and Norepinephrine Functional Regulation of DA D1 Receptors
in Unilateral Rotenone lesioned Parkinson’s Rat Mdel.
Jes Paul, Nandhu M.S, Korah P. Kuruvilla and C.S.Paulose
Molecular Neurobiology and Cell biology Unit, Centre for Neuroscience, Department of Biotechnology,
Cochin University of Science and Technology, Cochin – 682 022, Kerala, India. Email:
[email protected]
Background: Parkinson’s disease (PD) is a
progressive neurodegenerative disorder
characterized by selective degeneration of
dopaminergic neurons in substantia nigra (SN)
pars compacta leading to marked reduction of
dopamine (DA) levels in the striatum.
Method: The present study analysed the effect of
neurotransmitters as treatment on rotenone
induced hemi-Parkinson’s disease in rats and its
244
role in the regulation of DA D1 receptor in the
corpus striatum (CS) and cerebral cortex (CC) of
the experimental rats. Unilateral stereotaxic single
dose infusions of 1 µl of rotenone (8µg/µl) were
administered to the substantia nigra of adult male
Wistar rats. Neurotransmitters –serotonin (5-HT),
dopamine and norepinephrine (NE) treatments
were given to rotenone induced hemi-Parkinson’s
rats.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Result and conclusion: Scatchard analysis of DA
D 1 receptors showed a significant decrease
(p<0.001) in the CS and a significant increase
(p<0.001) in the CC in the PD rats compared to
control. These altered parameters were reversed
to near control in the 5-HT and NE treated PD
rats and no change was observed in DA treated
PD rats. Real-time PCR results confirmed the
receptor data. Cognitive and sensorimotor
activities were reduced in PD rats which were
reversed by 5-HT and NE. Our results showed 5HT and NE functionally reversed in DA D1
receptors in rotenone induced hemi-Parkinson’s
rat. This has clinical significance in the therapeutic
management of Parkinson’s disease.
Acknowledgement:This work was supported by
research grants from DBT, DST, ICMR, Govt. of
India and KSCSTE, Govt. of Kerala
Abstract No: 9.3
Dopamine D1 Receptor Up Regulation In Cerebellum and Brain Stem In Unilateral
6-Hydroxy Dopamine Rat Model: Antagonism By Serotonin And Gamma Amino
Butyric Acid
Nandhu. M. S, Jes Paul, Korah P Kuruvilla and C S Paulose*
*
Molecular Neurobiology and Cell Biology Unit, Centre for Neuroscience, Department of
Biotechnology, Cochin University of Science and Technology, Cochin-682 022, Kerala, India. Email:- [email protected]
Background: Parkinson’s disease (PD) is a severe
and progressive neurodegenerative disease
characterized by resting tremor, cogwheel rigidity,
bradykinesia and loss of postural reflexes. There
is degeneration in the central and peripheral
nervous systems in Parkinson’s disease,
predominantly in dopaminergic nigrostriatal
neurons.
Methods: In the present study, the effects of
serotonin, gamma-aminobutyric acid intranigrally
to substantia nigra individually on unilateral 6hydroxydopamine infused Parkinson’s rat model
was analyzed.
hydroxydopamine infused Parkinson’s rat
compared to control. Real Time PCR amplification
of Dopamine D1 receptors were up regulated
(P<0.001) in cerebellum and brain stem of 6hydroxydopamine infused rats compared to
control. Behavioural studies were carried out to
confirm the biochemical and molecular studies.
Serotonin and gamma-aminobutyric acid
supplementation reversed these changes to control.
Our results showed that serotonin and gammaaminobutyric acid treatment functionally reversed
DA D1 receptor in unilateral 6-hydroxy dopamine
infused Parkinson’s model. This is suggested to
have clinical significance in the management of
Parkinson’s disease
Results: Scatchard analysis of dopamine D1
receptor binding parameters using [3H]SCH Acknowledgement: This work was supported by
23390 showed a significant increase in Bmax research grants from DBT, DST, ICMR, Govt. of
(P<0.001) in cerebellum and brain stem of 6- India and KSCSTE, Govt. of Kerala
245
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 9.4
Status of Enzymatic and Non-Enzymatic Anti-Oxidant Systems in Patients with
Acute Ischemic Stroke
J. Sudha Rani
Assistant Professor, Dept of Medical Biochemistry, GVP Biomedical Engineering College for Women,
Visakhapatnam, AP.
Objective: Oxidative stress is probably involved
in neuronal damage induced by ischemiareperfusion. The present study was designed to
measure the enzymatic and non enzymatic
antioxidant status following acute ischemic stroke
patients with large vessel and small vessel infarcts.
Methods: The study included 72 subjects in which
30 were controls and 42 were acute ischemic
stroke cases. They were diagnosed basing on
clinical manifestations and by CT scan of the brain.
The cases were further divided into 2 groups. The
ischemic stroke patients with large vessel infarcts
(Group-L) and small vessel infarcts (Group-S)
based on CT scan of the brain. Serum enzymatic
antioxidants (superoxide dismutase and
glutathione peroxidase) and the non enzymatic
antioxidants (reduced glutathione, vitamin E and
vitamin C) were estimated in all the subjects by
using spectrophotometer.
Results: Ischemic stroke cases had significantly
lower levels of enzymatic and non enzymatic
antioxidants, compared to controls which is
statistically significant (p<0.05). The Group L
ischemic stroke cases had statistically significant
(p<0.05) lower levels when compared to Group S
ischemic stroke cases.
Conclusion: The antioxidant activity of serum may
be an important factor providing protection from
neurological damage caused by stroke-associated
oxidative stress. The present study suggest that
reduced antioxidant status may be used as an
indirect evidence of oxidative stress induced
neuronal damage in acute ischemic stroke which
may be useful for monitoring and optimizing
antioxidant therapy.
Abstract No: 9.5
Nitric Oxide and Lipid Profile in Type II Diabetes Mellitus— A Case Control Study
in East Sikkim
Dr A Ghosh, Ms Y Bhutia, Dr T A Singh and Dr M L Sherpa
Department of Biochemistry, Sikkim Manipal Institute of Medical Sciences, 5th Mile Tadong, Sikkim737102, Email- [email protected]
Objective: Diabetes Mellitus has reached epidemic proportions with an alarming rise in the
Asian countries including India. This particular
study has been taken up to compare the serum NO
level in patients with diabetes and healthy controls and to establish correlation between serum
246
nitric oxide level and diabetes mellitus in Sikkim.
Methods: Lipid Profile and serum nitrite were
assayed in 52 subjects, 26 of which were diagnosed
cases of type II Diabetes Mellitus undergoing treatment in SMIMS and 26 were healthy volunteers.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
The statistical analysis was done using SPSS 17 cantly lower in Diabetics in comparison to non
and the comparison between cases and control was diabetics (p=0.001). Total Cholesterol was markedly lower in diabetics but this difference was stacalculated by Student’s t –test.
tistically insignificant.
Results: Most of the patients were above 40 years
of age. Mean serum nitrite was lower in diabetics Conclusion: The pattern of findings in our studin comparison to non-diabetics but the difference ies is consistent with the findings elsewhere but
was insignificant (p=0.141). Triacylglyerol, LDL not statistically significant. This could be due to
were markedly raised in Diabetics but statistically the duration of diabetes and the role of drugs, diinsignificant (p=0.08), (p=0.55). HDL was signifi- etary and lifestyle modification prior to the study.
Abstract No: 9.6
Blood Glucose in Small for Gestational Age Infants
Arvindkumar Chowdhary, R Nisarga, C S Muralidhara Krishna and K L Mahadevappa
Dept. of Pediatrics and Dept. of Biochemistry, Kempegowda Institute of Medical Sciences, Bangalore.
Background: Small for gestational age (SGA)
babies have a higher metabolic rate than the
appropriate for gestational age (AGA) infants of
the same size and are more prone to hypoglycemia
that can result in brain damage,mental retardation
and cerebral palsy.
SGA female infants—50.00mg%
Methods: Present study is an assessment of the
frequency of hypoglycemia and its clinical
manifestations in SGA neonates. Singleton live
born babies, born at KIMS Hospital, who were
below the tenth percentile were taken as SGA
infants. Randomely chosen 200 cases each of SGA
& AGA infants in which 52% were male, 54.5%
were of gestational age of < 37 weeks and 50%
were in the birth weight ranging from 15002400gs. Blood sugar was estimated on a routine
chemistry analyser in cord blood just after birth
and cubital venous cord blood at 2—3hrs, 6hrs,
12hrs and 24hrs of life.
Mean blood glucose level at 0 hr of age is nearly
normal in both SGA and AGA babies but the
glucose level falls to hypoglycemic levels within
2-3hrs of extrauterine life more commonly in SGA
babies (46.02 mg% in SGA babies as against 51.62
mg% in AGA babies).Hypoglycemic babies
presented themselves with signs and symptoms
such as lethargy, convulsions, apnea, refusal to
feed, tachycardia, jitteriness and the state of
collapse.
Resulst: Mean blood sugar level at 0 hr and 2—
3hrs of age in different groups is as follows: 0 hr2—3hrs, SGA preterm infants— 51.90mg% —44.75 mg%
SGA fullterm infants— 54.13mg% — 47.07 mg%
SGA male infants — 55.00mg% — 47.00 mg%
— 44.oo mg%
SGA infants weighing less than 1500gs
52.77mg% —46.15mg%
—
SGA infants weighing more than 1500gs —
53.07mg% —46.01mg%
Conclusion: Thus the study suggests
that screening of all babies for hypoglycemia at 0
hr, 2-3hrs, 6hrs, 12hrs and after, if necessary, of
birth should be mandatory and babies at the risk
of developing hypoglycemia should be identified.
Early intervention with 10% dextrose helps to
alleviate the neurological sequale and prevents the
burden of mentally and /or physically impaired
children.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 9.7
Insulin Resistance and Lipid Profile in Pregnancy Induced Hypertension
Asmathulla S. and Rajagovindan D Jakanattane
Department of Biochemistry, Sri Manakula Vinayagar Medical College & Hospital.
Results: Fasting insulin and HOMA-IR are
significantly increased in PIH cases compared to
controls. Among PIH cases, Preeclampsia showed
significant increase in Insulin and HOMA-IR
levels compared to controls and gestational
hypertension. Total cholesterol, LDL cholesterol
Methods: Twenty eight PIH cases and ten normal and triacylglycerol are elevated significantly in
healthy pregnant controls are recruited for this PIH. The preeclamptic cases are associated with
study. Serum Insulin levels are measured by significant rise in total cholesterol, LDL
ELISA method. HOMA-IR is calculated by cholesterol, VLDL cholesterol, and triacylglycerol
(fasting insulin x fasting glucose)/22.5. Total as compared to controls but these changes are not
cholesterol, triglycerides, HDL-cholesterol and significant in gestational hypertension.
glucose are measured using enzymatic kits using
autoanalyzer. VLDL-cholesterol is calculated by Conclusion: The data from the present study
documents Hyperinsulinemia, Insulin Resistance
Friedwald’s formulae.
and Dyslipidemia in PIH patients.
Objective: To study fasting insulin levels and lipid
profile in Pregnancy Induced Hypertension (PIH)
cases and to compare them with normal pregnant
controls. To calculate insulin resistance in PIH and
to compare them with healthy pregnant controls.
Abstract No: 9.8
Thyroid Status in Hospital Based Cases from Rajendra Institute of Medical Sciences,
Ranchi
*Dr K. K. Sinha and **Dr. B. R. Ekka
*Prof. and Head of Department, **Assistant Prof, Dept of Biochemistry , RIMS, Ranchi, Jharkhand
E-mail: [email protected]
Objective: The incidence of thyroid disease in
the patients referred to the Biochemistry Lab,
Department of Biochemistry , RIMS Ranchi
was studied by analysis of thyroid hormone by
ELISA. Data for prevalence of thyroid disease in
patients at Jharkhand has not been analysed and
the study was undertaken to generate such data.
Past three years data has been analysed to know
the age, sexwise and tribal prevalence of thyroid
disease, to detect subclinical thyroid dysfunction
and thyroid hormone levels.
assay (ELISA). The criteria for evaluating the
functional status of the thyroid was based on
normal values given by ELISA kits ( T3 -0.52-1.85
ng/ml ; T4 male 4.4 - 10.8 µg/dl, female 4.8-11..6
µg/dl ; TSH 0.39 – 6.16 µIU /ml).
Results: Three years data (2006, 2007, 2008) has
been analysed. Out of a total of 2016 cases there
were 1153 with normal thyroid status, and rest 863
with overt or subclinical disease and follow up
cases. The preliminary observations are – (1) The
prevalence of thyroid disease amongst women in
Methods: Thyroid hormone tests which included the age group 20 – 50 yrs is very high (84.7%).
Total T3, Total T4 and TSH were performed by (2) Incidence of overt hyperthyroidism (20%) and
the method of Enzyme Linked Immunosorbant hypothyroidism (23%) are almost equal. (3)
248
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Subclinical thyroid disease is 21% of the total, out
of which subclinical hypothyroidism being 84%
and subclinical hyperthyroidism being 16%. (4)
157 cases were of tribal population which was 8%
of the total, out of which 31% were suffering from
thyroid disease. (5) The ELISA kits were sensitive
enough to detect changes in thyroid hormone levels
and concurrent with clinical symptoms. Follow up
studies of 91cases suggest the usefulness of these
tests in diagnosis and treatment of patients.
Abstract No: 9.9
Effect of Iron Deficiency Anemia on Glycosylated Hemoglobin Levels in Type 2
Diabetics.
Dr.B.Shanthi M.D
Associate professor, Dept. of Biochemistry, Sree Balaji Medical College & Hospital, ChrompetChennai; E mail id- [email protected]
Objective: Glycosylated hemoglobin is a very
important parameter to measure glycemic control.
Diabetes is now a disorder of lower socio
economic population too. Hence important
variable “iron deficiency anemia” & its effect on
glycosylated hemoglobin is studied.
25 Controls - non diabetics aged 25- 50 were
estimated for glycosylated hemoglobin & ferritin
levels. Glycosylated Hb- ion exchange resin
chromatography; Serum ferritin- ELISA.
Conclusion: From this study we could infer that
iron deficiency anemia increases glycosylated
Methods- Subjects : 100 type 2 diabetic patients hemoglobin levels & this has to be definitely taken
aged (25-50) with good glycemic control - into account while interpreting glycosylated Hb.
Estimated for glycosylated hemoglobin & ferritin.
Abstract No: 9.10
Minerals Status in Thyroid Disorders (Hypo & Hyper thyroidism)
B.Suneel, D.R.Nagendra, K.Ramalingam and J.N.Naidu
Department of Biochemistry, Narayana Medical College, Nellore.
controls Ca+ levels are (12.96 ± 11.1) Increased
P levels are (2.01 ± 1.03) Decreased Mg+ levels
are (3.8 ± 1.91) Increased Zn+ levels are (167.42 ±
120.7)Decreased. In Hyperthyroidism compared
to controls Ca+ levels are Decreased (6.60 ± 2.78)
2+
Methods: The studies includes 25 controls with , P levels are Increased (7.07 +± 3.05), Mg levels
normal TSH, T3& T4 . 25 Thyroid disorders having are Decreased (1.8 ± 0.87), Zn levels are Increased
below 4 years in age group of 30 – 48 years both (60 ± 30.86).
sex were included TSH, T3, T4 was estimated by Conclusion: In this study the hypothyroid patients
using ELISA Ca was estimated OCPC method should increased Ca and Mg levels decreased, P
,Mg2+ GEDTA method, Zn+ Nitro PAPS , P
and Zn levels in hyperthyroid patients should
Molybdate method.
Decreased Ca and Mg levels, increased P and Zn
Results: In hypo thyroid patient compared with levels
Objective: The Study was under taken to evaluate
the changes of minerals in Thyroid disorders (hypo
& hyper). TSH, FT3 & FT4 as markers of hypo &
hyper Thyroidism & mineral Status Ca+, P+, Mg+,
Zn+ are parameters studied.
249
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 9.11
The Role of Salacia Oblonga in Maintaining Glucose and Lipid Homeostasis in
Diabetic Rats
Bhagyajyothi.D °, Dr.Vivian D’Souza ¹, Dr.Poornima Manjrekar ², & Dr.C.V.Raghuveer ³,
° - Senior Research Fellow, Department of Biochemistry, Kasturba Medical College, Mangalore, ¹ Professor& HOD, Department of Biochemistry, Kasturba Medical College, Mangalore, ² - Associate
Professor, Department of Biochemistry, Kasturba Medical College, Mangalore, ³ - Professor of
Pathology, Melaka Manipal Medical College, Manipal; E mail: [email protected]
Objective: To study the effect of a hydroalcoholic
root extract of Salacia oblonga on blood glucose,
serum Total Cholesterol (TC), Triglycerides(TG),
and HDL- Cholesterol(HDL-C) levels on long
standing diabetes.
Results: It was observed that there was a
significant reduction in RBS levels in Salacia
treated rats. The rats fed with 50mg/kg/day showed
28% decrease in RBS (P= 0.018), whereas the
group treated with 100mg/kg/day showed 18%
reduction (P= 0.012). Either of the groups did not
Methods: Streptozotocin (STZ) induced diabetic show significant change in the lipid profile. The
Wistar rats of either sex were treated with two oral plasma TC, TG and also HDL-C levels were
doses of Salacia oblonga extract, 50mg/kg/day and slightly low in 50mg/kg/day group, but did not
100mg/kg/day for a period of 16weeks. Random attain statistical significance when compared with
blood sugar (RBS) was estimated on Day-1 and at diabetic controls.
the end of 16 weeks (previous day of estimating
the lipid profile) by ACCU-CHEK Active Blood Conclusion: The hydroalcoholic root extract of
Glucose Monitor from Roche with disposable Salacia oblonga lowers the RBS in diabetic rats.
strips from the same company. The fasting serum Its effect on lipid profile is not significant on long
TC, TG and HDL-C were estimated at the end of standing diabetic rats. There was no appreciable
16 weeks in the Autoanalyser, HITACHI-917 using effect of higher dosage (100mg/kg/day) over
50mg/kg/day.
Roche Kits.
Abstract No: 9.12
Glycemic Control and Complications of Diabetes Mellitus
Adiga Usha 1 and Adiga MNS2
1
Assistant Professor, Biochemistry, KMC, Manipal,
Manipal
Objective: According to the American Diabetes
Association’s Clinical Practice recommendations,
monitoring of glycemic status is considered a
cornerstone of management of diabetes mellitus
in order to minimize the complications. The
objective of our study is to find the relationship
between the glycemic status and common
complications seen in them.
250
2
Associate Professor, Pharmacology, KMC,
Methods: One hundred and five diabetic patients
receiving treatment were seen over a period of one
year. Among these, patients with diabetic
nephropathy, retinopathy, diabetic ulcers and
urinary tract infections were segregated. Fasting,
postprandial blood sugar (monthly) and
glycosylated hemoglobin (once in three months)
were estimated. The analysis was carried out by
means of Graphpad statistical package.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Results: A total of 60 patients had the above
complication (15 each). The average duration of
the diabetes was 8.65± 1.26, 10.37± 1.25,
13.23±1.75 and 8.86±0.87 years respectively in
patients with diabetic retinopathy, nephropathy,
diabetic foot ulcers and urinary tract infections.
We found that the highest FBS, PPBS and
glycosylated hemoglobin was seen in patients who
had diabetic retinopathy (160.67±10.32,
221.50±9.0, 8.04±0.87 respectively). The lowest
values were seen with urinary tract infection
(144.17±11.0, 213.50±5.68, 7.77 ±0.47). There
was a statistically significant difference between
these groups (p<0.05). The re was no much
difference between the other two parameters.
Conclusion: - We conclude from our study that
urinary tract infections are commonly seen with
earliest alternation of blood sugar. Retinopathy was
seen in patient with high blood sugars and
glycosylated hemoglobin values though it has
manifested early compared to other complications.
Abstract No: 9.13
Relationship of Staple Diet and Abnormal Thyroid Function Observed in
Outpatients at Ujjain (MP)
Mane A. Y.*, Bhagwat V. R.** Potey G G* and Gaikwad S B**
*Dept of Biochemistry, RD Gardi Medical college, Ujjain (MP), **Dept of Biochemistry, SBH Govt
Medical College, Dhule (Maharashtra); Email: [email protected]
Background: Thyroid function abnormalities are Results: It was observed that mean T3 T4, TSH
common in general population. Among several and T /T ratio were higher in mixed diet group
3
4
factors nutritional factors have detrimental effects
while T4, TSH/T3 ratio was higher in vegetarian
on thyroid functions.
group. Mean T3 and TSH/T3 were higher while
Methods: This study attempts to probe in to TSH levels were lower in Jowar group. Mean T
4
dietary pattern and thyroid functions in patients
and TSH/T4 ratio were lowest in Bajra group
reporting in urban hospital at Ujjain city (MP).
This is a hospital based study involving 165 whereas it was higher in Jowar group.
outpatients with clinically suspected thyroid Conclusion: The results indicate that Jowar as
dysfunctions. Thyroid function tests included
staple diet appears to promote hypothyroid state
circulating levels of free T3, T4 and TSH as
determined by micro particulate enzyme while wheat and rice promote hyperthyroid state.
immunoassay technique.
Abstract No: 9.14
Evaluation of Cardiovascular Risk Markers in First Degree Relatives of Type 2
Diabetes Mellitus
H. Nandeesha, V. Sathiyapriya, Zachariah Bobby, Aparna Agrawal1 and N. Selvaraj
Department of Biochemistry and Medicine1, JIPMER, Puducherry.
Objective: The objective of the study is to Methods: 29 first degree relatives of type 2
evaluate cardiovascular risk markers in first degree diabetes subjects and 32 controls were enrolled in
relatives of type 2 diabetes mellitus.
the study. Subjects with history of diabetes,
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
hypertension, myocardial infarction, infections
and those who are on any kind of medications were
excluded from the study. Fasting glucose, lipid
profile, insulin, glycated hemoglobin, C-reactive
protein and protein bound sialic acid were
estimated in both the groups.
Results: Insulin, Total cholesterol, triglyceride,
glycated hemoglobin, C-reactive protein and
protein bound sialic acid were significantly
increased in first degree relatives of type 2 diabetes
subjects compared to controls.
Conclusion: Insulin resistance, dyslipidemia and
inflammation can enhance the risk of
cardiovascular disease in first degree relatives of
type 2 diabetes mellitus.
Abstract No: 9.15
Lipid Profile and Glycemic Status in Non- smoking Type 2 Diabetes Mellitus on
Treatment with Oral Hypoglycemic Drugs
J. Sandhya, B.R.Shyam Prasad and U.Satyanarayana
Department of Biochemistry, Siddartha Medical College, Dr. NTR University Of Health Sciences,
Vijayawada, Andhra Pradesh. – 520008; Email: [email protected]
Background: Macro and micro vascular
complications are the leading causes of mortality
and morbidity in type II diabetic patients. These
vascular complications are mainly due to
dyslipidemia.
Objective: The objective of this study was to
elucidate glycemic status and lipid profile in non
– smoking type II diabetics belonging to low socio
- economic group and attending Government
General Hospital, Vijayawada, and on treatment
with oral hypoglycemic drugs.
Methods: Seventy patients (aged 35 – 70 years)
with history of 5 – 15 years of type II diabetes and
on treatment with oral drugs (metformin,
glibenclamide, etc..) and 35 age matched healthy
controls were the subjects of this study. Blood
samples were collected after keeping the
individuals on overnight fast. Serum samples were
estimated for triacylglycerol, total cholesterol and
HDL cholesterol by enzymatic methods using kits.
VLDL and LDL cholesterol were calculated by
using Friedewald formula.
Results: The diabetic patients had relatively higher
fasting and post - prandial blood glucose levels
compared to controls. Serum triacylglycerol, total
cholesterol, VLDL and LDL cholesterol
concentrations were also higher in diabetics
compared to healthy individuals. Further, serum
HDL concentration was lower in diabetics when
compared to controls.
Conclusion: It appears from this pilot study that
type II diabetics of low socio - economic group,
mainly depending on the government general
hospital for their health care, are not fully under
control with regard to glycemic status and lipid
profile despite the use of oral drugs.
Abstract No: 9.16
Thyroid, Lipid and Glycemic Profile in Dyslipidemia and Altered Thyroid Status
Dr.Sridevi , Dr.Vivian D’souza, Dr.Poornima Manjrekar and Dr.Vinit Anand
Email ID: [email protected]
Objective: To study lipid and glycemic
252
abnormalities in subclinical hypothyroidism cases
Indian Journal of Clinical Biochemistry Supplement, 2009/24
& thyroid and glycemic abnormalities in
dyslipidemia patients & to compare the same with
euthyroid, overt hypothyroid and hyperthyroid
subjects.
hypothyroid group. Both hypothyroid and
hyperthyroid pools had higher FPG values, but
fructosamine levels were highest in hypothyroid
followed by subclinical hypothyroid &
hyperthyroid pool. Among dyslipidemic patients,
Methods: A total number of 150 subjects, 30 FPG was higher with comparable fructosamine
newly diagnosed hypothyroid, 30 newly and lower TSH with normal T ,T .
3 4
diagnosed subclinical hypothyroid, 30 newly
diagnosed hyperthyroid, 30 dyslipidemic patients Conclusion: Lipid profile is deranged in both
and 30 normal controls between the age 25-55 subclinical and overt hypothyroidism. All classes
years of both the sexes were chosen for the study of thyroid abnormalities except subclinical
and FPG, fructosamine, fasting lipid profile, hypothyroid showed propensity to develop
T3,T4,TSH were done in all subjects.
diabetes, fructosamine levels with highest in
hypothyroid cases and lowest in hyperthyroid. This
Results: The freshly diagnosed hyperthyroid could be because of altered protein metabolism in
patients had comparable lipid profile with the hyperthyroid cases. Dyslipidemic pool showed
controls except for high LDL values. In highest fasting plasma glucose levels pointing to
hypothyroid pool, TC, TG, LDL, VLDL were the possibility of correlation between higher lipid
found to be higher & HDL lower than the normal levels and hyperglycemia. Low TSH and
pool. Subclinical hypothyroid pool also showed a fructosamine observed in dyslipidemic patients can
similar picture except for comparable HDL levels. be attributed to the subclinical hyperthyroid state
This pool had lipid status similar to overt altering the aminoacid metabolism.
Abstract No: 9.17
Incontrovertible Behavior of Oxidative Stress in Etiopathogenesis of Diabetes
Mellitus or its Complications is Disputable
P.P. Singh, Anu Chandra, Chetna Vashishtha, Farzana Mahdi and Abbas Ali mahdi1
Department of Biochemistry, Era’s Lucknow Medical College & Hospital, Lucknow, (UP), India,
1
Department of Biochemistry, C.S.M. Medical University, Lucknow, (UP), India
Background: Unfortunately India topped the list
of diabetic population. In the recent years, raised
oxidative stress (OS) has been claimed as one of
the significant risk factors. The two main proposed
hypotheses are: a) raised OS can trigger DM by
inducing insulin resistance which is a cardinal feature of DM and b) hyperglycemia raises OS which
exacerbate multiple risk cascade resulting in diabetic complications. Our observations do not unequivocally support either of these claims.
dant defense system is an essential component of
DM or associated complications.
Methods: The study included 209 diabetic patients
(Type 1-70 and Type 2-139) and 131 matched controls. Serum/RBC lipid peroxidation levels (LPO
expressed as nmol/ml), and antioxidant complement was examined.
Results: LPO levels were raised in diabetics
(4.95±2.19) as compared to controls (2.88±1.29),
DMT-1 patients had slightly but significantly
Objective: To evaluate whether raised OS due to
higher (5.22±2.24) than DMT-2 (4.67±2.09). Its
heightened lipid peroxidation or weaker antioxi253
Indian Journal of Clinical Biochemistry Supplement, 2009/24
level in different DMT-2 groups was: without complications - 3.81±1.32, with cardiovascular disease 4.49±1.78, retinopathy 2.86±2.11, neuropathy 3.84±1.52 and nephropathy 4.70±0.95.Salient
findings are a) in none of the groups all patients
had raised OS b) DM with complications did not
show raised LPO levels than those without complications c) mean GSH levels were slightly but
significantly lower in patients but neither it could
be categorized as depleted or low d) Antioxidant
levels in diabetic and control did not offer any conclusive explanation.
Conclusion: Though there is compelling evidence
that OS can potentiate and contribute to risk in
DM or its complications, our data suggest that
under clinical setting its role is generally facultative rather than obligatory
Abstract No: 9.18
A Comparative Analysis of Anthropometric Measurements, Lipid Profile, Fasting
Insulin and HOMA2-IR to Identify Insulin Resistance in Overweight Individuals
Dr.M.D.Sreenivasa murthy 1, Dr. Manjunath M Tembad 2, and Dr. Jayaprakash Murthy DS 3
1 Postgraduate student, 2 Professor, 3, Professor & HOD, Department of Biochemistry, J.J.M.Medical
College, Davanagere – 577004, Karnataka state. Email ID [email protected]
Background: Insulin resistance is more common
in overweight individuals and is associated with
metabolic syndrome which increases one’s risk for
the development of type-2 diabetes mellitus and
cardiovascular disease.
using Microsoft Excel® based HOMA-2
calculator.
Results: The optimal cut-off values for
identification of insulin resistance in overweight
individuals were: 144 mg/dL for triglycerides
Objective: This study was carried out to evaluate (sensitivity-66%; specificity-83%), 3.4 for TG/
the ability of anthropometric measurements, lipid HDLc ratio (sensitivity-68%; specificity-90%),
profile and fasting insulin to predict insulin and 17µU/mL for fasting insulin (sensitivity-74%;
resistance and their correlation with HOMA2-IR specificity-100%). Linear regression analysis
in overweight individuals.
showed a significant linear relationship between
HOMA2-IR and the following parameters: waist
Methods: The present study included 120 subjects
circumference, BMI, serum triglycerides, TG/
comprising of 60 healthy controls (BMI: 18.5HDLc ratio and fasting insulin (p<0.001).
24.9) and 60 overweight subjects (BMI: 25.0-29.9)
in whom the following parameters were measured: Conclusion: Triglyceride levels, TG/HDLc ratio
anthropometric
measurements
(waist and insulin concentration are practical methods for
circumference, waist-hip ratio, BMI Prime); identifying overweight persons who are insulin
fasting glucose, triglycerides, total cholesterol, resistant. In the absence of a standardized insulin
HDLc and LDLc (enzymatic methods by assay, we suggest that the most practical approach
autoanaylzer) and fasting insulin (ELISA by Bio- to identify overweight individuals who are insulin
rad microplate reader). HOMA2-IR (updated resistant is to use the cut-off values for either
homeostasis model assessment) was calculated triglyceride concentration or the TG/HDLc ratio.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 9.19
Thyroid Hormone Levels in New Borns of Mothers with Gestational Diabetes
1Dr Geetha A, 2Dr Joseph P Thyparambil, 2Dr Sreekumari S, and 3Dr Sulekha B
1Assistant Professor of Biochemistry, Medical College, Kottayam; 2 Professor of Biochemistry S
Gokulam Medical College Thiruvananthapuram; 3 Professor of Biochemistry SUT Medical College
Thiruvananthapuram. Email address: [email protected]
Objectives: The present study was done to assess the glycated haemoglobin levels. The glycated
the thyroid status of new borns of mothers with haemoglobin levels were estimated during the third
trimester of pregnancy.
gestational diabetes.
Methods:
The
thyroid
hormones,
Tetraiodothyronine, Tri iodothyronine, and
Thyroid Stimulating Hormone were estimated in
cord blood. The thyroid function tests were done
by the ELISA method, the blood glucose by
glucose oxidase-peroxidase method and glycated
haemoglobin by the cation exchange resin method.
Results: In the present study the tri iodothyronine
levels in cord blood were found to be much higher
than normal range. Normally the triiodothyronine
levels are lower in cord blood (4-141 ng/dl) as
compared to the adult (70-207 ng/dl).
Triiodothyronine levels in cord blood also
showed a statistically significant positive
correlation with the severity of maternal diabetes
as judged by post prandial blood sugar levels and
Discussion: The increase in Triiodothyronine
levels in cord blood may be due to foetal
hyperglycaemia and the resulting foetal
hyperinsulinsm. In the mother when the blood
glucose levels are high the intracellular entry of
glucose is low due to insulin resistance. The foetus
of a mother with gestational diabetes is exposed
to hyperglycemia due to transplacental transfer of
maternal glucose .This stimulates the foetal
pancreas to produce more insulin. In the
foetus,there is no insulin resistance and the increase
in both glucose and insulin levels facilitates the
entry of more glucose into the foetal cells which
may enhance the activity of 5’ deiiodinase causing
increased formation of T3 from T4.This may be the
reason for increased T3 levels in cord in correlation
with maternal hyperglycemia
Abstract No: 9.20
Lp(a) in Hypothyroidism
F.S.Geethanjali* , M.S. Seashadri** and A.S. Kanagasabapathy***
Departments of Clinical Biochemistry*, Endocrinology ** and Former Professor in Clinical
Biochemistry*** , Christian Medical College, Vellore.
Objective: Thyroid disorders are known to
influence the lipoprotein metabolism. In
hypothyroidism the plasma concentrations of the
LDL fraction is elevated. Since Lp(a) and LDL
share the apoB100 in common, this study is to
evaluate the Lp(a) levels in Hypothyroid patients
and its risk for artherogenesis in them.
Methods: Eighty four primary hypothyroid
patients attending the Endocrinology Clinic and
sixty four euthyroid subjects were included in the
study. Serum Lipid profile, thyroid function tests
and plasma Lp(a) levels were performed.
Results: The thyroid profile showed typical
euthyroid and hypothyroid patterns. The mean age
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
for both the groups was comparable. Total
cholesterol, triglycerides and LDL cholesterol
were significantly elevated in the hypothyroid
patients. HDL was marginally increased but not
statistically significant. The plasma Lp(a) levels
were markedly increased in hypothyroid compared
to the euthyroid.
Conclusion: The hypothyroid induced changes in
lipoprotein metabolism could directly or indirectly
promote atherogenesis. The elevated cholesterol
and LDLc fraction may be due to the reduced
activity of the LDL receptor. There are suggestions
that the Lp(a) concentrations depend on the amount
of apo(a) available for binding to apoB100 and
not vise versa. The thyroid hormones which are
known to affect the biosynthesis at the
transcriptional and / or translational level of the
apoprotein could reasonably exert an effect on
apo(a) synthesis. But it is unclear whether the
increased synthesis or the decreased catabolism
could be the cause of Lp(a) elevation in
hypothyroid patients.
Abstract No: 9.21
Role of Myelin Oligodendrocyte Glycoprotein and Galactocerebroside Antibodies
on Phosphorylation and Degradation of Myelin Basic Protein In Isolated Myelin:
Implications in Multiple Sclerosis.
Krishnakumar Menon*# Sidhy Viha C.V*+., Krishna Prasad G.N*+. and Claude C.A. Bernard#
*Institute of Molecular Medicine, +Department of Biochemistry, Amrita Institute of Medical Sciences,
Elamakkara, Kochi, India and #Monash Immunology and Stem Cell Laboratories, Monash University,
Clayton, Victoria, Australia. email:[email protected]
Background: In Multiple Sclerosis (MS), both
neuronal and myelin damage is the cause of the
ensuing neurodegeneration leading to
neurological deficit. This process results from an
autoimmune attack on myelin in combination with
genetic susceptibility and the involvement of an
unknown environmental factor. Although the
pathogenic role of immunoglobulins (Igs) directed
to myelin antigens in inducing myelin/
oligodendrocyte damage have been elucidated,
how the pathogenic Igs induce biochemical
breakdown of myelin is poorly understood. Role
of MS Igs as well as monoclonal antibodies
(mAbs) directed to myelin oligodendrocyte
glycoprotein (MOG) and Galactocerebroside
(GalC), in inducing significant myelin basic
protein (MBP) degradation mediated by neutral
proteases in myelin had been shown. MBP plays
a pivotal role in the structural organization of
myelin. Thus breakdown of MBP could lead to
myelinolysis.
256
Methods: In order to elucidate the mechanism by
which specific anti-MOG and anti-GalC antibodies
induce MBP degradation, we have investigated the
possible ways by which MBP is made vulnerable
to proteolysis as well as the relationship between
Gal C and MOG.
Results: In this report, we demonstrate that
antibodies to GalC and MOG induced
phosphorylation of MBP prior to its degradation
in isolated human myelin. Neither such a
phosphorylation nor a degradation of MBP could
be observed using antibodies directed against MBP
or a plant glycoprotein (control Igs).
Conclusion: We here suggest that phosphorylation
of MBP may result in the exposure of MBP to
proteolysis as a result of poor MBP-lipid
interaction leading to myelinolysis. It is likely that
these demyelinating antibodies may mimic the
naturally occurring ligands to MOG/GalC and we
propose a possible interaction between MOG and
GalC in inducing myelin damage thus exploiting
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.1
Glycosylated Hemoglobin Levels in Relation to Antioxidant Status and Lipid Profile
in Type 2 Diabetes Mellitus Patients
Prasiddha Tilak1, Mahesh S1, Naureen Anwar1 and Dr Mungli Prakash1
1
Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka-576104, E-mail for
correspondence: [email protected]
Objective: Type 2 Diabetes Mellitus (Type 2 DM)
is a metabolic disorder related to either insulin
deficiency or resistance. Glycosylated
Hemoglobin (HbA1c) is used to monitor long term
regulation of blood glucose. Studies relating
HbA1c with antioxidant status and lipid profile
are very few. Present study was carried out to
determine the relation between HbA1c and
antioxidant markers along with lipid profile in
these patients.
Results: There was significant increase in fasting
plasma glucose (FPG) (p<0.001), HbA1c
(p<0.001), LDL-C (p<0.001) and ceruloplasmin
(p<0.001), and there was significant decrease in
serum thiols (p<0.001), GST (p<0.001), and HDLC (p<0.001) in type 2 DM patients compared to
healthy controls. HbA1c correlated positively with
FPG (r = 0.749, p<0.001), LDL-C (r = 0.513,
p<0.001), and ceruloplasmin (r = 0.568, p<0.001)
and negatively with HDL-C (r = -0.715, p<0.001),
Methods: Blood samples were collected from thiols (r = -0.704, p<0.001) and GST (r = -0.426,
healthy controls (n=55) and Type 2 DM patients p<0.001).
(n=55) and their fasting lipid profile and HbA1c Conclusion: Findings in our study indicate the
levels were determined using auto analyser. possibility of increased glycation of bio molecules
Antioxidant status markers such as serum thiols, and enhanced generation of free radicals leading
ceruloplasmin and GST are measured to deficient antioxidant status and altered lipid
profile in favour of increased atherogenesis
spectrophotometrically.
Abstract No: 10.2
Lipid Indices in Type 2 Diabetes Mellitus and Their Association with Macro and
Micro-vascular Complications
Dr. Imran Ahmed Siddiqui a , Dr. J Rama Rao b and Dr. Prabhavati Modi c
a
Postgraduate MD biochemistry, Department of Biochemistry Osmania Medical College, Hyd.
b
Former Professor & Head Department of Biochemistry, Osmania Medical College, Hyd.
c
Professor & Head Department of Biochemistry, Osmania Medical College, Hyd.
Email: [email protected]
Objective: To identify changes in lipid
metabolism in Type II DM in context with the
glycemic status, its relative impact on the macro
& micro vascular events, and the effects of insulin
therapy on the lipid indices.
method, Triglyceride levels by GPO-PAP method
and HDL-C by using the phosphotungstate
precipitation and CHOD-POD method. The
Cholesterol/ HDL-C ratio and Atherogenic Index
(AI) [Logarithm (log) of TG/HDL-C] were then
Methods: 158 Type II diabetics as cases and 30 calculated.
subjects without any coincidental illness as Results: Atherogenic index and CHOL/HDL-C are
controls were selected for the study. Total significantly higher in diabetics than in controls
cholesterol was measured using the CHOD-POD and in uncontrolled diabetics than controlled
257
Indian Journal of Clinical Biochemistry Supplement, 2009/24
diabetics. Both the indices were also found to be
lowered in patients on treatment with insulin. The
AI in patients with complications was also
significantly higher than those without
complications; However CHOL/HDL-C was not
significantly different. Thus using the best cutoff
values AI can be used as a better indicator for
complications than using the ratio of CHOL/HDL-C.
Conclusion: An imbalance between the LDL and
HDL particles, where in, increase in the number
of small and dense LDL and decreased HDL levels
leads to atherogenic dyslipidemia and increased
incidence of plaque. Both lipid indices indicated
dyslipidemia in diabetics and lower values were
associated with glycemic control and insulin
therapy. Hence AI can be considered as a
diagnostic marker of increased cardiovascular risk
in patients with Type II DM, and a guide for
aggressive therapeutic approach.
Abstract No: 10.3
Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in
Type-2 Diabetes.
Dr. Itishri Jena and Prof. Prakash Ch. Mohapatra
S.C.B. Medical College and Hospital, Cuttack, Orissa, India. Email id: [email protected]
Objective: Diabetes Mellitus is the leading
endocrine disorder of global interest that leads to
thromboembolic phenomena in future. The
pathogenesis of diabetic vascular disease is not
clearly known. Haemorrheological as well as
hypercoagulable states have been suggested to
cause this complication. In order to asses the status
of coagulation, we investigated prothrombin time
(PT) and activated partial thromboplastin time
(APTT) in diabetic patients and their relation with
blood glucose, Glycated haemoglobin (HbA1c)
and insulin resistance.
Methods: A study was undertaken to evaluate
these parameters in 60 diabetics and 30 normal
controls attending the out and in-patient
department of S.C.B. Medical College and
Hospital, Cuttack, during the period from July
2008 to March 2009. Both PT and APTT were
measured by an automated blood coagulation
analyzer, CA-50, manufactured by Sysmex.
Results: The average age of cases was 51.55 years
with average duration of disease 5.8 years. Both
PT and APTT were observed to be shorter in
diabetics than in controls; though within normal
range. The fall is more marked in diabetics with
complications (p<0.05). Both PT and APTT
revealed association with hyperglycemia and
insulin resistance.
Conclusion: Our study revealed an association
between shortened PT and APTT with
hyperglycemia which may lead to thromboembolic
complications in future. Identification of such
factors may allow identifying that subset of
diabetic patients at risk of thromboembolic
complications and special preventive measures
may be provided to them.
Abstract No: 10.4
Effect of Trigonella Foenum Graecum and Insulin on Altered Membrane Functions
in Alloxan Diabetic Rat Brains
Pardeep Kumar, Asia Taha, R.K. Kale and Najma Zaheer Baquer
School of Life Sciences, Jawaharlal Nehru University, New Delhi, India, Email: [email protected]
Objective: To study changes in monoamine
oxidase (MAO) activity, lipid peroxidation and
258
insulin levels, membrane fluidity and lipofuscin
accumulation occurring in diabetic rat brain and
Indian Journal of Clinical Biochemistry Supplement, 2009/24
to see whether these changes are restored to accumulation in total brains of rats. Activity of
normal levels after administration of insulin and catecholamine degrading enzyme, MAO showed
Trigonella foenum graecum powder (TSP).
a significant increase in the synaptosomes
membrane fractions of whole brain in diabetic
Methods: Animals were made diabetic by animals. Present study also showed that insulin
injecting 15mg/100g body weight alloxan, to administration and TSP to diabetic animals
24hours starved rats. Diabetic animals were given significantly decreased MAO activity, lipid
Trigonella seed powder (5% w/w) mixed with their peroxidation, membrane fluidity and lipofuscin
standard food for 21 days. MAO activity was accumulation in brains of rats.
assayed in synaptosomal and supernatant fractions
of the brain. Lipid peroxidation was measured in Conclusion: It can therefore be suggested that
different brain regions by measuring formation of Trigonella foenum graecum (TSP)’s beneficial
4-Hydroxynonenal (4HNE) levels. The presence effects on metabolic parameters is due to their
of lipofuscin was observed by fluorescence antioxidative,
antilipofuscin
and
microscopy in different brain regions. Insulin antilipidperoxidative actions. The results of such
studies will be useful for pharmacological
levels were measured using ELISA.
modification of the diabetic process, for
Results: Present work revealed that alloxan development of new antidiabetic drugs and
diabetes was associated with significant increases normalizing the metabolic syndrome.
in MAO activity, lipid peroxidation and lipofuscin
Abstract No: 10.5
Metabolic Syndrome in Type 2 Diabetes Mellitus
Priya.K.Dhas*, Janet**, Shantharam** and Dr. Rita Mary Aruna *
*Department of Biochemistry, Penang International Dental College, Vinayaka Missions University,
Salem ** Department of Biochemistry, Madurai Medical College, Madurai. [email protected]
Objective: Insulin resistant patients are at an
increased risk of developing metabolic syndrome,
a major cause of heart disease and dyslipidemia.
Metabolic syndrome is a cluster of metabolic risk
factors that come together in a single individual.
Hence in the present study the prevalence of
metabolic syndrome among Type 2 diabetes
mellitus by WHO criteria has been carried out.
The risk factors are compared between patients
with Type 2 diabetes mellitus with and without
metabolic syndrome.
Methods: 87 age matched Type 2 diabetic patients
attending a diabetic clinic were included in this
study. The biochemical parameters like FBS,
PPBS, lipid profile were estimated using
diagnostic kits. Blood pressure was measured and
BMI was calculated. The prevalence of metabolic
syndrome was carried out by classifying the
parameters based on WHO criteria.
Results: The prevalence of metabolic syndrome
as per WHO criteria was 33% in Type 2 diabetic
patients. A significant increase was seen in TGL,
VLDL, TGL/HDL ratio, BP, BMI and a decrease
was observed in HDL of Type 2 diabetic patients
with metabolic syndrome when compared with the
Type 2 diabetic patients without metabolic
syndrome.
Conclusion: The significant increase in TGL,
TGL/HDL ratio, BP, BMI of diabetic patients with
metabolic syndrome when compared to the Type2
diabetic patients without metabolic syndrome
predicts that patients with Type 2 diabetes mellitus
with metabolic syndrome are at a higher risk level
for CHD.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.6
Study of the Effects of HCN Exposure in Cassava Workers
Priya.K.Dhas, P.Chitra and Dr. Rita Mary Aruna
Department of Biochemistry,Penang International Dental College, Vinayaka Missions University,
Salem. [email protected]
Objective: Hydrogen cyanide is one of the
chemicals responsible for tissue hypoxia. Chronic
exposure to HCN may cause neurological,
respiratory, cardiovascular and thyroid defects.
Onset of symptoms depends on dose and duration
of exposure. Large scale of cassava processing
could be disastrous due to discharge of
hydrocyanic acid into the air. Hence the present
study is taken to assess the thyroid dysfunction
leading to impairment in energy metabolism.
Methods: 25 cassava workers in Salem and age
matched controls were taken up for this study.
Their clinical history was obtained and the
following parameters are estimated using a fasting
blood sample. Blood sugar, lipid profile, serum
total protein, urea, creatinine and T3, T4, TSH are
estimated using diagnostic kits.
Results: Our study reveals a significant increase
in triglycerides and TGL/HDL ratio which is a risk
factor for cardiovascular disease. This triglyceride
is predominantly endogenous and may be
synthesized from sugars that cannot enter energy
producing pathways. The results of T3, T4 and TSH
will be discussed.
Abstract No: 10.7
Prevalence of Obesity in Female Students Residing in Hostels in the University
Campus of Manipal
Rosemol Jacob M, Yeshoda K, Elsa Maria, Uma Pallavi, Asha Kamath, Dr. Revathy P Shenoy
and Dr. Anjali Rao
Department of Biochemistry, Kasturba Medical College Manipal, India-576104,
E mail: [email protected]
Objective: The fact that women are most
vulnerable to obesity and our observation that
considerable number of females residing in
Kasturba medical college (KMC) hostels are
gaining weight made us take up this study.
Although obesity is a prevalent problem in all
parts of world, very few data are available
regarding obesity among young Indian women.
This study was conducted to explore the problem
among the female hostel inmates and to identify
different factors contributing to obesity.
Methods: Survey approach was a nonexperimental study in which we investigated 266
female hostel inmates of age group 17-27. Their
260
biometrical characters such as height, weight, body
mass index (BMI), waist-hip ratio (WHR), waist
circumference (WC) and food habits were studied.
Data analysis was done using SPSS (version 14).
Results: According to waist-hip ratio, 227(85.3%)
out of 266 females were found to be overweight
where as only 32(12%) females were found to be
overweight when BMI was considered.
Conclusion: Significant correlation was observed
between the different biometric characters. Since
WHR is a slightly stronger predictor of CVD risk
than WC or BMI, the female inmates of KMC
Hostels, Manipal are susceptible to disorders
associated with obesity.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.8
In Vitro Effect of Visfatin on Glucose Utilization by Visceral Adipose Tissue
Radhika G1, Magnus J2, Sasikala M1, Venkat Rao G, Pradeep Rabella and Nageshwar Reddy D
1
Asian Healthcare Foundation, 2Asian Institute of Gastroenterology; 6-3-661, Somajiguda,
Hyderabad- 500 083. E-mail: [email protected]
Background: Visfatin a novel adipokine earlier
recognized as pre â cell colony enhancing factor
(PBEF), predominantly expressed in visceral
adipose tissue has distinct activities of central
importance in cellular energetics and innate
immunity. It is recently shown to have insulin
mimetic effects, bind and activate insulin receptor
through a different binding site other than insulin,
thus stimulate glucose utilization in peripheral
tissues as well as reduce release of glucose from
hepatocytes.
conditions. At required intervals glucose in the
medium was estimated by GOD-POD method
using UV-Visible spectrophotometer. Insulin
receptor phosphorylation was estimated by ELISA
method.
Results: Visfatin treatment significantly increased
(P< 0.001) insulin stimulated glucose utilization
and insulin receptor phosphorylation in visceral
adipose tissue obtained from lean subjects with
normal BMI without central obesity. However,
increase in visfatin induced insulin stimulated
Objective: Present work was intended to study glucose utilization was not observed in tissues
the invitro effect of visfatin on insulin stimulated obtained from overweight and obese subjects under
glucose utilization by visceral adipose tissue identical experimental conditions.
explants obtained from lean, overweight and obese
Conclusion: In conclusion, our result shows that
human subjects. Results may have therapeutic
visfatin enhances insulin stimulated glucose
implication in metabolic syndrome.
utilization in lean human subjects. The observed
Methods: Visceral adipose tissue explants inability of visfatin to increase insulin stimulated
incubated in DMEM (nutrient medium with glucose utilization in overweight as well as obese
1000mg/l glucose) with insulin were exposed to subjects is substantiated by the insulin resistant
visfatin and glucose under optimal experimental nature of those subjects.
Abstract No: 10.9
Salivary Cortisol Level in Depression Patients
Sukanya Shetty1, Suhas Pattar2, Satheesh Rao3 and Srinivas Bhat4
a
Student, K.S.Hedge Medical Academy, Mangalore, 1 Professor & Head, Dept. Biochemistry;
K.S.Hedge Medical Academy, Mangalore, a2Student, K.S.Hedge Medical Academy, Mangalore, 3 HOD,
Dept. Psychiatry; K.S.Hedge Medical Academy, Mangalore, d Asst Prof, Dept. of Psychiatry; K.S.Hedge
Medical Academy, Mangalore.
Backgfound: Major depressive disorder is a state activities of daily living for long period of time
of intense sadness, melancholia or despair that Major depression does not have any specific
disrupts individual’s social functioning and/or markers but recent studies have shown that in
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
depressive patients there is an elevated level of
Salivary Cortisol. It is said that about 50% of
patients with major depression hypersecrete
Cortisol, which may be secondary to HPA
overdrive. AIM: To compare the level of salivary
cortisol in depressed patients and normal people.
Methods: All 40 subjects were given GHQ
(General Health Questionnaire). The subjects who
score less than 20 in the GHQ were selected as
control group (N -20) and the subjects who score
more than 20 and fulfill the ICD-10 criteria for
depression were selected as active group (N- 20).
Psychiatrist diagnosed depression and also
assessed the Severity of depression by HAMD(Hamilton Depression Scale). Morning
sample(9:00am-12:00pm) of Saliva was collected
in a sterile plastic tube and stored under 0 degree
Celsius refrigeration till the sample was analyzed
for cortisol level.
Results: The Mean of the Salivary Cortisol in
Depression Patients was 1.81+0.54 ug/dL. Mean
of the Salivary Cortisol in Control was 0.71+0.21
ug/dL. The mean difference were statistically
significant, Z- value was 3.431 and the difference
was found to be statistically significant @p<0.001.
Mean Salivary cortisol level was low in the group
at the GHQ Scoring 20-30 1.6+0.29 and higher in
the GHQ Scoring of 30 and above. This was not
significant.
Conclusion: The Salivary Cortisol level was found
to be significantly higher in depressed patients as
compared with the controls.
Abstract No: 10.10
Atherogenic Index of Plasma and its Relationship with Fasting Blood Glucose in
Diabetes Mellitus Patients.
Supriya M, Kavya R, Phani M.N, .Jeevan K Shetty and Mungli Prakash
Department of Biochemistry, Kasturba Medical College, Manipal-576104
E-mail id: [email protected]
Objective: Dyslipidemia is very common in
patients with diabetes mellitus. Diabetic
dyslipidemia is characterized with increase plasma
triacyglycerol and decrease HDL concentration.
In present study we measured atherogenic index
of plasma (AIP) & its relationship with fasting
blood glucose in diabetes mellitus patients.
Methods: Fasting glucose, fasting lipid profile and
AIP were estimated in 50 diabetes mellitus patients
and 50 healthy controls. Lipid profile and fasting
blood glucose was analyzed by auto analyzer. AIP
was calculated using formula log [TG/HDL-C].
Results: There was significant increase in Fasting
blood sugar, total cholesterol, triacyglycerol, LDL
262
cholesterol and AIP observed in cases (p<0.001)
compared to healthy controls. There was
significant decrease in HDL cholesterol (p<0.001)
in cases compared to controls. Significant positive
correlation was observed between fasting glucose
&AIP (p<0.05) in cases.
Conclusion: According to previous studies,
elevated AIP levels increases the risk for
development of atherosclerosis. In our study we
observed elevated AIP in diabetic patients which
predisposes them for development of
atherosclerosis. The positive correlation between
fasting blood glucose and AIP indicates poorly
control of diabetes mellitus has got enhanced risk
for development of atherosclerosis.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.11
Lipoprotein (a), Fibrinogen, C – Reactive Protein, Uric Acid and Microalbuminuria
in Coronary Artery Disease and Diabetes Mellitus”
Suvarna.T. Jadhav*, Dr. A.V. Sontakke** Dr. B.M. Tiwale*** and Dr. Mrs. C.C. Khanwelkar**
Department of Pharmacology, Krishna Institute of Medical Sciences, Karad;
*Department of Biochemistry, B. V. U. Dental College and Hospital, Sangli; ** Department of
Biochemistry, Krishna Institute of Medical Sciences, Karad; *** Department of Biochemistry, Dr.
D.Y. Patil, Medical College, Kolhapur; E-mail ID – [email protected]
Objectives: 1) To study biochemical parameters Results: Significant increased in the levels of Lp
(a) (P < 0.001), Fibrinogen (P < 0.001), C –
as cardiac markers, like,
Reactive Protein (P < 0.001), Sr. Uric Acid (P <
a. Serum Lipoprotein (a)
0.05) & microalbuminuria (P < 0.001) was
observed in patients with CAD & DM as compared
b. Plasma Fibrinogen
to normal healthy controls.
c. C – Reactive Protein
Conclusion: The increased incidence of CAD in
d. Serum Uric Acid
patients with DM may be due to increased levels
e. Microalbuminurea
of Lp(a) and Fibrinogen in DM patients which may
2) To study these parameters in patients of CAD be responsible for modified blood coagulation
mechanisms. Increased C – Reactive protein
with DM.
values may predict future cardiovascular disease,
3) To establish the correlation between CAD and
atherosclerosis being an inflammatory disorder,
DM with reference to above parameterts.
Elevated Sr. Uric Acid has been found to be closely
Methods: Following methods were used for associated with dyslipidemia, abesity,
estimation. 1.Lipoproein(a) by latex turbidimetry; hypertension, diabetes, smoking & inflammation
2 Fibrinogen by DADE. Behring method; 3 C- which are well known risk factors of CAD.
reactive protein by turbilatex method; 4 Serum Microalbuminuria is associated with wide spread
uric acid by Trinder method; 5 Microalbuminuria abnormalities in the vasculature that may manifest
by immunoturbimetric method.
as altered vascular reactivity and endothelial
dysfunction.
Abstract No: 10.12
Is hsCRP an Independent Risk Factor in Type 2 Diabetes?
Dr.V.S. Kalaiselvi
Associate professor, Dept. of Biochemistry, Sree Balaji Medical College & Hospital, Chrompet-chennai;
Email id:- [email protected]
Background: Diabetic patients are known to have hsCRP( high specific C-reactive protein) a
a manifold risk for coronary heart disease and molecule produced in response to inflammation ,
other complications. In Type 2 Diabetes, elevated is found to be an independent risk factor.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Objective: 1. To estimate the level of hsCRP in latex turbidimetry. Lipid profile, blood sugar &
non diabetic and diabetic individuals. 2. To find others investigations were done by routine methods.
any correlation between hsCRP levels and lipid
Results: Significant rise in hs CRP levels is noticed
profile in type 2 diabetes.
in diabetic patients when compared to non diabetic
Methods: 100 individuals (n=100) were included individuals. hs CRP levels are correlating well with
and grouped as follows, Group 1- patients with serum TGL levels in type 2 diabetics.
type 2 diabetes (n=50) Group 2- non diabetic
individuals (n=50); hs CRP level estimated by Conclusion: Elevated hs CRP levels, in type 2
Diabetes may be considered as an independent risk
factor.
Abstract No: 10.13
Oxidative Stress and Proteolytic Activity in Erythrocytes of Diabetic Patients
Dr. Varashree B S1 and Dr.P.Gopalakrishna Bhat2
1
Assistant Professor, Department of Biochemistry, 2Professor, Department of biochemistry, Kasturba
medical college, Manipal- 576104; Email Address: [email protected]
Objective: To evaluate oxidant stress status in
diabetes mellitus and its association with
proteolytic system in erythrocytes. The parameters
assessed are erythrocyte malondialdehyde (MDA)
levels and proteolytic enzyme activity in both
diabetic individuals and controls.
Methods: 51 non diabetic patients (mean
age=54.47); 53 diabetic patients (mean age=52.92)
were included in the study. The diabetic status was
assessed by estimating the fasting blood sugar
(FBS) using glucose oxidase method. Oxidant
stress was measured by estimating erythrocyte
MDA in terms of thiobarbituric acid reacting
substance (TBARS). Proteolytic activity by the
amount of amino group released by the erythrocyte
lysate of the diabetic individual using
phenylhydrazine treated hemoglobin as substrate.
Results: Erythrocyte MDA was higher in diabetics
(4.7±1.7nmoles/gHb) than the controls
264
(3.3±2.2nmoles/gHb) [p=0.001]. Erythrocyte
proteolytic activity was higher in cases (167.2±648
nmoles/gHb) than the controls (27.9±31.7 nmoles/
gHb). FBS did not correlate with the erythrocyte
MDA in diabetic patients and erythrocyte
proteolytic activity. No correlation between
erythrocyte MDA and erythrocyte proteolytic
activity in cases.
Conclusion: The erythrocyte lipid peroxidation
was increased in diabetic patients. The proteolytic
activity in the erythrocyte lysates of diabetic
patients was significantly increased. There was no
correlation of proteolytic activity and the TBARS
in erythrocytes of diabetic subjects. Diabetes is
associated with a significant increase in TBARS
which is an index of oxidant stress. Proteolytic
enzymes degrade many oxidatively altered
proteins preventing the accumulation of altered and
damaged proteins in the cell.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.14
Leptin Levels in Early Post Transplant Period: Can it be Used to Assess Changes in
Body Composition ?
Victoria Job, Venkataramana Raju* and George T John*
Clinical Biochemistry, * Nephrology, Christian medical college, Vellore
Background: Weight gain is common after renal
transplantation, influenced by improved appetite
and a reversal of the uremic state. An increased
centripetal obesity and muscle atrophy accompany
the long term glucocorticoid requirements. Such
changes in body composition are associated with
an increased risk of cardiovascular complications,
which is a major cause of morbidity and mortality
in renal transplantation.
33.4±11.2, had a mean weight of 52±10.1, 56.8±9.3
and 57.7 ±9.6 kg at base line 3, 6 months
(p<0.01).The mean body fat at base line, 3 & 6
months were 11.1±5.7, 13.9±5.7 and 14.5±6.2 kg
(p <0.001). The fat increment in arms, legs and
trunk were 37.4%, 31.6% and 36.6%. Total bone
mineral content decreased significantly at 6
months. The mean Leptin levels 5.3±7.9, 6.0± 8.4
and 15.4± 17.4 ng/ml (p<0.05) and it positively
correlated with total body and regional fat content
Objective: To assess the changes in body
(p<0.01).
composition and Leptin levels in the early post
transplant period.
Conclusions: Post renal transplant patients gain
significant amount of weight, mostly due to
Methods: Consecutive renal allograft recipients
accumulation of fat, especially around arms and
were assessed prospectively at baseline, 3 and 6
trunk. There is overall decrease in bone mineral
months post-transplant by anthropometry, DEXA
content,
predominantly
in
the
and serum Leptin levels.
spine.Anthropometric measurements of fat content
are a reasonable substitute for DEXA. Leptin levels
Results: 62 recipients (M: F=3:1), mean age
correlate with body fat content.
Abstract No: 10.15
Inhibition of Type I 5á-reductase
Vijaya Patil a, Debjani Dasgupta a, Grace Samual b, Shubhangi Mirapurkar b, and Krishnamohan b
a.Department of Biochemistry, The Institute of Science, 15 Madam Cama Road, Mumbai - 400032,
India.; b. Board of Radiation and Isotope Technology,Vashi complex, Navi Mumbai-400705
Objective: Aim of this study was to investigate
the inhibition of 5á-reductase type I enzyme using
extracts from Indian medicinal plants. This
enzyme converts testosterone into metabolites
such
as
dihydroxytestosterone
and
androstenedione. Type I 5á-reductase has been
implicated in skin disorders such as acne,
hirsuitism and male pattern baldness and its
inhibition offers a potential treatment for these
disorders.
Methods: Plant extracts selected for this study
were screened and selected based on their ability
to inhibit acne-causing microorganisms. PC3 cell
lines were used as a source of 5á-reductase type I
enzyme and experiments were conducted at pH7
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
(optimum pH of the enzyme). PC3 cells were
incubated for varying time intervals with
testosterone (1.25 µM) in steroid free medium in
presence or absence of increasing doses of seven
plant extracts. Dutasteride and Finasteride were
used as standards. The rate of uptake of
Testosterone
was
studied
using
radioimmunoassay.
kurroa, Vitex negundo and Embelia ribes were
potent inhibitors of 5á-reductase type I enzyme
compared to known inhibitors such as Dutasteride
and Finasteride.
Conclusion: The present study indicates that
extracts from Picrorhiza kurroa, Vitex negundo and
Embelia ribes may be used for treatment of skin
disorders involving 5-á-reductase type I enzyme.
Results: It was found that extracts of Picrorhiza
Abstract No: 10.16
Thyroid Function in Diabetic Subjects
Ranjani.P and Vijaya Srinivasan
Department of Biochemistry, Sri Ramachandra Medical College and Research Institute, Sri
Ramachandra University, Chennai.
Objective: Diabetes mellitus and thyroid disease
are the two common endocrinopathies seen in
adult population. Insulin and thyroid hormone
being intimately involved in cellular metabolism
excess or deficit of either of these hormones could
result in the functional derangements of the other.
Several studies have documented the prevalence
of the thyroid disease in women with prevalence
rates ranging from 4 to 21%and the rate in men
being 2.8 to 16%. However the studies on the
association of thyroid disease and diabetes are
scarce. Failure to recognize the presence of
abnormal thyroid hormone levels in diabetes may
be the primary cause of poor management often
encountered in some treated diabetics. The present
study was therefore undertaken to evaluate the
thyroid function in diabetic subjects.
Methods: The study was undertaken at Sri
Ramachandra Medical College, Chennai. People
in the age group of 30-60 years with diabetes
mellitus were included for this study. The control
group consisted of normal subjects in the age
group of 30-60 years. The blood sample obtained
266
from the patients was processed. The thyroid
hormones T3, T4, TSH and FT4 were analyzed by
using automated analyzer ADVIA Centaur system.
Results: The T3 concentration was lower (p<
0.001) in diabetic patients compared to normal
subjects. A significant negative correlation was
observed between the fasting blood glucose and
T3 levels (r = -0.41) in diabetic patients. The
decreased T3 levels could probably be due to
decreased peripheral conversion of T4 to T3,
increased degradation or clearance of T3 or else
increased T3 metabolism via alternative pathway
other than deiodination. No significant variation
in T4,TSH and FT4 were observed in diabetic
subjects.
Conclusion: The finding of the present study
suggests that alteration of thyroid hormone is a
characteristic feature in diabetic patients. The
detection of abnormal thyroid hormone levels in
the early stage of diabetes mellitus will help the
patients to improve quality of life and reduce the
morbidity rate. Thus evaluation of thyroid profile
is essential in diabetic subjects.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.17
Atypical Findings of Oral Glucose Tolerance Test (OGTT) Curve in Gestational
Diabetes Mellitus (GDM)
Shivaraj Gowda, P B Desai, Vijayetha S Kagwad, Sindhu J Shetty and M B Ilakal.
Department of Biochemistry, J. N. Medical College, Belgaum 590010, Karnataka
Email: [email protected]
Background: Gestational diabetes mellitus is
defined as any glucose intolerance detected during
pregnancy associated with the metabolic risk of
type-2 diabetes mellitus and high risk of maternal
and perinatal morbidity. Early diagnosis is very
important to prevent the complications and OGTT
is the preferred test to detect GDM. The objective
of the study was to analyze the pattern of OGTT
curve and to understand the response of Insulin
to the glucose metabolism.
Methods: A total of 96 pregnant women at high
risk were undertaken for OGTT and test performed
at 24-28 weeks of gestation using 100gms of
glucose. The test results were plotted on a graph
and interpreted using Carpenter and Coustan
criteria.
Results: 15 women were diagnosed as GDM and
5 out of them show atypical patterns in OGTT
curve. Similar such patterns were also seen in 5
normal subjects.
Conclusion: The shape of the OGTT curve is
related to glucose metabolism, â-cell function and
insulin sensitivity. Pregnancy is a state of
physiologic insulin resistance. Insulin secretion
pattern is disturbed in patients with insulin
resistance. The atypical findings of OGTT will be
discussed in the scientific presentation
Abstract No: 10.18
Insulin Level in Obese Patients with Obstructive Sleep Apnea Syndrome.
Yogendra Singh, Surya Prakash Bhatt, *Randeep Guleria, and Manjit Singh Dhillo
Department of Medicine All India Institute of Medical Sciences New Delhi-10023
Background: Obstructive sleep apnea (OSA) is
caused by either complete obstruction or by partial
obstruction of the upper airway and is known to
be associated with metabolic, cardiovascular and
neuropsychological disorders. OSA may correlate
with Insulin resistance. Indians are more prone to
Insulin resistance. We studied the correlation
between Insulin levels and OSA in obese Indian
patients.
levels were measured by Radio Immuno assay
(RIA). Subjects with Apnea hypopnea index (AHI)
>10/h were considered as obese with OSA and
subjects with AHI <5/h were considered as obese
without OSA.
Results: In this study, 49 % had severe, 14.6 %
moderate and 19.4 % mild OSA and 17 % had
normal study. BMI was high in severe OSA as
compared to normal subjects. Mean AHI levels
Methods: We enrolled 41 obese patients with
significantly correlated with Insulin levels in the
suspected sleep disordered breathing. Informed
consent was taken. Demographic data and blood patients with OSA (p = 0.03). The mean serum
samples were collected. All patients underwent a insulin levels was high in patients with OSA but
split night polysomnography and serum insulin not statistically significant when compared to
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
normal controls (p= 0.268). Overall obese subjects
had 40 % higher serum insulin levels.
Conclusion: We found a significant correlation
between AHI and Insulin levels in Indian patients
with OSA. A larger sample size is needed to
validate these finding and evaluate the relationship
between insulin levels and OSA
Abstract No: 10.19
Study of Lipid Profile, Oxidative Stress and Enzymatic Antioxidant in Type-2
Diabetes Mellitus
Youb Raj Neupane *, Dr Sandeep Roy**, and Dr Z G Badade***
*P.G. Student, *** Professor & Head, Department of Biochemistry, **Associate Professor, Dept of
Medicine, MGM Medical College, Kamothe, Navi-Mumbai, Pin-410 209 [email protected]
Objective: A distinguishable feature of type-2
diabetes besides hyperglycemia and deranged lipid
profile is an impaired insulin secretion, peripheral
insulin resistance, obesity and biological events
due to oxidative stress has become major health
concern worldwide.
Methods: The study was designed to find out
correlation between lipid peroxidation, enzymatic
antioxidant and lipid profile, to rule out oxidative
stress in type-2 diabetes mellitus. Patients with
type-2 diabetes were diagnosed on the basis of
WHO criteria. The degree of lipid peroxidation
was measured in terms of malondialdehyde
(MDA); enzymatic antioxidant viz. superoxide
dismutase (SOD) along with lipid profile to assess
the status of oxidative stress in type-2 diabetic
patients in comparison to the normal control.
Results: There was significant increase in the
product of lipid peroxidation and lipid profile
except HDL cholesterol and superoxide dismutase,
which was found, decreased in comparison to the
normal control. From present study, it is clearly
evident that type-2 diabetic patients were more
prone to oxidative stress.
Conclusion: It is concluded that controlling of
hyperglycemia will prevent alteration in lipid
metabolism and degree of oxidative stress that
definitely plays an important role in prognosis and
prevents secondary complications in type-2
diabetes mellitus.
Abstract No: 10.20
Assay of CRP and HbA1C in Smokers and Nonsmokers with Type 2 Diabetes Mellitus
in a Segment of Indian Urban Population
Rajyalakshmi Amancherla and Pradeep Naik
Objective: Elevated high-sensitivity C-reactive
protein (hsCRP) levels have been shown to be
associated with type 2 diabetes mellitus (T2DM).
The aim of the study was to assess the association
of hsCRP with type 2 diabetes and to determine
its correlates with HbA1C in a segment of urban
population from the twin cities of Hyderabad.
268
Methods: HbA1C and hsCRP were measured in
545 urban subjects by cation exchange
chromatography and ELISA respectively.
Results: Our results showed that a significant
increases in hsCRP levels were observed with a
mean (± SD) values of 1.65 ± 0.02 mg/L in normal
Indian Journal of Clinical Biochemistry Supplement, 2009/24
smokers when compared to normal non smokers
who had mean (± SD) of 0.96 ± 0.02 mg/L.
HbA1C levels were also significantly increased
in smokers who showed 6.5 %± 0.1 whereas non
smokers showed 5.5 % ± 0.1 value. In the case of
diabetes group smokers showed significantly
higher values of hs CRP and HbA1c than their
non smoker counterparts. The diabetic smokers
showed 3.3 ± 0.2 mg/L hs CRP whereas the
diabetic non smokers showed 2.1 ± 0.3 mg/L hs
CRP in the serum. Similarly the diabetic smokers
showed 9.2 % + 0.2 HbA1c whereas the diabetic
non smokers showed 7.99 % + 0.3 HbA1c in the
blood. All the subjects were free from
hemoglobinopathies and any other blood disorders.
We demonstrate the association of low-grade
systemic inflammation, as indicated by elevated
hsCRP levels, with T2DM in Indian population.
Smoking seems to play a major role in the increase
of systemic inflammation irrespective of blood
glucose levels.
Abstract No: 10.21
Association of ApoA5 1131 T>C Polymorphism with Triglyceride Levels in Indians
R.Lakshmy, HPS Sachdev, Meenakshi Sharma, SK Bhargava, GR Chandak and KS Reddy
Cardiac Biochemistry, AIIMS, New Delhi
Objective: ApoA5 gene occurs near the ApoA1/
C3/A4 cluster on human chromosome 11q23.
Knocking out ApoA5 gene in mice increases
triglycerides by a factor of four. A polymorphism
in the non coding region located 5’ to the ApoA5
gene at nucleotide 1131 has been shown to be
associated with high triglyceride levels in humans.
The polymorphism results from T to C substitution
at 1131. AopoA5 -1131C has been reported in 78% of Caucasians, 33% of Chinese and 35% of
Japanese population. Since Indians have a higher
prevalence of metabolic syndrome characterized
by high triglyceride and low HDL, we looked at
the relative contribution of ApoA5 T1131C
polymorphism on triglyceride levels.
Methods: The study was conducted in 1300
adults residing in Delhi. Polymorphism at ApoA5
T1131C was assessed by ARMS PCR. The lipid
levels as well as LDL and HDL sub fractions were
determined in all the subjects.
Results: The associations of ApoA5 1131
genotype with lipid variables were computed. The
TT genotype was present in 66% of the population
studied, 30.5% had the TC genotype and 3.5% had
CC genotype with the minor allele (C) frequency
of 18.6%. This is higher than the 7-8% frequency
of minor allele of ApoA5 (1131) reported in
Caucasians. Subjects with CC had significantly
higher fasting and post prandial triglyceride levels
as compared to the subjects with TT genotype
(p<0.001). 25% of the subjects with TT genotype
had triglyceride >150, 32% of the subjects with
CT genotype had hypertriglyceridemia where as
45% of subjects with CC genotype had high
triglycerides. None of the other variables studied
showed any association with ApoA5 1131
polymorphism.
Conclusion: In conclusion ApoA5 variation may
be an important determinant of triglyceride levels
in Indians.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.22
Minerals Status in Thyroid Disorders (Hypo & Hyper Thyroidism)
B.Suneel,D.R.Nagendra, K.Ramalingam and J.N.Naidu
Department of Bio-chemistry, Narayana Medical College, Nellore.
Objective: The Study was under taken to evaluate
the changes of minerals in Thyroid disorders (hypo
& hyper). TSH, FT3 & FT4 as markers of hypo &
hyper Thyroidism & mineral Status Ca+, P+, Mg+,
Zn+ are parameters studied.
Increased P levels are (2.01 ± 1.03mg/dl)
Decreased Mg+ levels are (3.8 ± 1.91mg/dl)
Increased Zn+ levels are (167.42 ± 120.7ug/dl)
decreased. In Hyper-thyroidism compared to
controls Ca+ levels are decreased (6.60 ± 2.78mg/
dl) , P levels are Increased (7.07 ± 3.05mg/dl),
Methods: The studies includes 25 controls with
Mg2+ levels are Decreased (1.8 ± 0.87mg/dl), Zn+
normal TSH, T3& T4 . 25 Thyroid disorders having
levels are Increased (60 ± 30.86ug/dl).
below 4 years in age group of 30 – 48 years both
sex were included TSH, T3, T4 was estimated by Conclusion: In this study the hypothyroid patients
using ELISA Ca was estimated OCPC method should increased Ca and Mg levels decreased, P
,Mg2+ GEDTA method, Zn+ Nitro PAPS , P and Zn levels in hyperthyroid patients should
Molybdate method.
Decreased Ca and Mg levels, increased P and Zn
levels.
Results: In hypo thyroid patient compared with
controls Ca + levels are (12.9 ± 11.1mg/dl)
Abstract No: 10.23
Postprandial Hyperglecaemia and Reduction in Serum Paraoxonase Activity in
Type 2 Diabetes Mellitus Subject: an Alarm of Vascular Complication
Raj Narayan Gupta*, Neelima Singh, S.K. Singh and Preeti Dohare
*P.G. Department of Life Sciences, IASCA, ITM Universe, Gwalior, Department of Biochemistry,
G.R. Medical College, Gwalior (M.P.),: [email protected])
Objective: The present study aimed to investigate
Results: Significant decrease in PON activity
PON activity and Lipid profile along with Lipid
along with HDL-c in type 2 diabetic is observed
per oxidation in different group of diabetic and
with increased postprandial hyperglycemia and
non diabetic with and without macro vascular
HbA1c. the reduction in PON activity is further
complication and age matched healthy control.
confirmed by elevation of Pro-oxidant P-MDA.
Methods: Blood samples were obtained from
patients admitted in ICU or attending to OPD of
Medicine of J.A. Group Hospital attached G.R.
Medical, Gwalior. The Blood sugar (PPBS),
HbA1c were measured in all the samples.
270
Therefore PON activity along with HDL-c could
be considered as diagnostic marker for macro
vascular complications in NIDDM subjects and
reduction in PON activity along with HDL-c can
be alarming condition for uncontrolled
postprandial hyperglycemia.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 10.24
Anti-oxidant Potential (AOP) of LDL in Post Menopausal Women Suffering from
Type 2 Diabetes Mellitus.
Nivedita Singh, Neelima Singh, Sanjeev Singh and Vishal Bhargava
Department of Biochemistry, G.R. Medical College, Gwalior
Objective : Menopause occurs as the age
advances in life of women (40-50 years). Post
menopausal phase is associated with absence of
estrogen known to be cardio protective and potent
antioxidant hormone. A strong association of
absence of estrogen and cardiovascular
complication in post menopausal diabetic female
has been reported.
and 50 post menopausal diabetic female subjects.
Results: It is concluded from study that in these
subjects
besides
hyperglycemia,
hypertryglyceridemia and hypercholesterolemia
also exists. LDL and VLDL were increased
(P<0.001) with decrease of HDL cholesterol
(P<0.001).
Methods: The present study has been carried out Conclusion: Sensitivity for oxidation of LDL in
in 50 age matched healthy female (40-50 years) these subjects were found increased and therefore
antioxidant potential (AOP) of LDL was decreased.
Abstract No: 10.25
Analysis of Multivariate Factors in Metabolic Syndrome - a Correlation Study
Vinayak S Bhat 1, Reshma Kumarchandra 1, and Vijay S. Bhat 2
1. Kasturba Medical College, Mangalore, 2. Manipal Hospital Bangalore
Background: Metabolic syndrome is a
combination of medical disorders that increase the
risk of developing cardiovascular disease and
diabetes. It is a multifactorial disorder
encompassing abdominal obesity, altered glucose
and lipid metabolism, insulin resistance,
hypoadiponectinemia, elevated blood pressure and
high level of CRP. For the present study, controls
were on prescribed diet and exercise and subjects
selected had most of the characteristics of
metabolic syndrome.
Objective: To estimate the parameters such as
Adiponectin, CRP and HOMA score, FBG, lipid
profile, Homocysteine, HbA1c & to make a
correlative study of multivariate factors using
Kruskal–Wallis one-way analysis of variance and
analysis of variance (ANOVA) involved in this
abnormal clinical condition and also to check
whether diet and exercise have any effect on
reducing the abnormal level of the different
parameters involved in this disorder.
Methods: Two categories of subjects were taken
for the study, first category consisting of controls
(10 members) and second category consisting of
tests (61 members). Fasting insulin was estimated
by electrochemiluminiscence method. HS-CRP by
Immunonephelometric method, plasma
Adiponectin was estimated by ELISA. FBG was
by Hexokinase method. Cholesterol was by
CHOD-POD method & Triglyceride by GPO-PAP
method. Statistical analysis was done by using
Kruskal – Wallis one way analysis of variance and
by ANOVA.
Results: Inverse relationship was observed
between Adiponectin level and HOMA score, as
well as with HS-CRP. A direct relationship between
CRP & Homocysteine, HOMA score &HbA1c,
history & Homocysteine, blood pressure &
Homocysteine was observed. These values were
statistically significant (p-value < 0.0001). Post
exercise for 2 months, there was an increase in
level of adiponectin in all the controls which also
271
Indian Journal of Clinical Biochemistry Supplement, 2009/24
indirectly brought in corrections in rest of the risk
factors. Conclusion: After all the investigation and
data analysis in this work on metabolic syndrome,
we observed altered levels of various parameters
like, CRP, adiponectin, homocystiene, lipid
profile, HOMA score(insulin resistance), blood
pressure, fasting blood glucose etc. When we
compared these parameters with the controls
parameters we observed a significant difference
in the values of parameters. So based on the results
of this study, we come to a conclusion that proper
diet and regular exercise has an effect on bringing
down the different parameters to normal level and
the persons who are on the borderline and prone
to develop the metabolic syndrome can reverse it
back with proper diet and exercise.
Abstract No: 10.26
Diabetes Risk Prediction by Fructosamine in Non diabetic First Degree Relatives
Hegde A, D’souza F, Kaveeshwar V, Jose A, Tasneem S, and Manjrekar AP
Dept. of Biochemistry, Kasturba Medical College, Mangalore-575004, Karnataka. Email:
[email protected]
Objective: A positive family history of diabetes
increases the chances of developing the disease
manifold. The earliest diagnostic marker is plasma
glucose value and long term follow up through
glycated hemoglobin (HbA1c). Fructosamine (FA)
depicting short term glycemic control has been
seldom tried. Hence, clinical usefulness of
fructosamine estimation and its comparison with
established markers before the actual onset of the
disease was the purport.
Waist Circumference (WC) and Blood Pressure
was recorded and compared between groups.
Results: Group III had significantly higher mean
FPG (150.26mg/dl) & HbA1c (8.23 %) values. In
addition significant elevation in salivary FA
(202.05 mg/dl) was also noticed. Group II was
associated with elevated serum FA levels (533.62
mg/dl), increased serum FA/ total protein (TP) ratio
& larger WC. In Group II it was also seen that
WC & BMI correlated significantly and positively
Methods: 23 non-diabetic first degree relatives with FPG (0.613, 0.400 respectively), while WC
of diabetics (Group II) were compared with 27 correlated importantly with systolic BP (0.526).
healthy controls (Group I) and 23 diabetic people
(Group III). Fasting plasma Glucose (FPG), Conclusion: Serum FA has less sensitivity in
Glycosylated hemoglobin (HbA1c), serum depicting chronic hyperglycemia as was seen in
Fructosamine and Total proteins were estimated case of diabetics. Monitoring serum FA along with
in fasting blood samples. Simultaneously saliva measures of WC and SBP could be used to foresee
was analyzed for fasting salivary glucose (SG), the development of Diabetes and Cardiovascular
salivary fuctosamine and Total proteins. BMI, disease in high risk individuals.
Abstract No: 10.27
A Study of CVD Risk Factors in Metabolic Syndrome.
Sajimon Thomas and T.Vijayakumar
Department of Biochemistry and Physiology, Educare Institute of Dental Sciences,Malapuram,
Kerala -675506, India.
Objective: Metabolic Syndrome is one of the
commonest risk factors for Cardiovascular
272
diseases. The major characteristics of metabolic
syndrome include insulin resistance, abdominal
Indian Journal of Clinical Biochemistry Supplement, 2009/24
obesity, elevated blood pressure and lipid
abnormalities.The present study was aimed at
establishing the link between Metabolic syndrome
and it’s role as an atherogenic risk factor in an
Indian perspective. It is now established that this
syndrome predicts the development of type 2
diabetes mellitus and cardiovascular
disease.[1]The prevalence of the metabolic
syndrome depends on age, ethnic background, and
gender. It rises linearly from 20 to 50 years and
plateaus thereafter. Looking at various studies
around the world, which included population
samples, aged from 20 to 25 and upwards, the
prevalence varies from 8% (India) to 24% (United
States) in men and from 7% (France) to 46%
(India) in women.1-3
fibrinogen, High sensitivity C reactive protein( hsCRP) and Insulin were analyzed in both Case
Group and Control Group
Results: The two sample t statistical analysis of
the results of the data from 225 individuals showed
a statistically significant increase in all parameters
in the Case Group compared to the Control Group
(p<0.001).
Conclusion: This establishes a strong link between
Metabolic Syndrome and atherogenic risk factors
substantiating similar observations elsewhere.
References:
1. Vega GL. Obesity, the metabolic syndrome,
and Cardiovascular disease. Am Heart J
2001;142:1108-16.
Methods: The study was carried out in 225
individuals and the selection was primarily based 2. Ramachandran A, Snehalatha C, Satyavani K,
on age, sex and socioeconomic status. 85 men and
Sivasankari S, Vijay V. Metabolic syndrome in
65 women in the age group of 30 to 50 years and
urban Asian Indian adults-a population study
who are having 3 or more of the classified
using modified ATP III criteria. Diabetes Res
manifestations of Metabolic Syndrome were
Clin Pract 2003;60:199-204.
included in the Case Group45 men and 30 women
in the age group of 30 to 50 years and who had 3. Deepa R, Shantiram CS, Premlalitha G, Shanti
NG, Mohan V. Prevalence of insulin resistance
none of the above mentioned manifestations
syndrome in a selected south Indian populationcomprised the Control Group. Blood/Serum
the Chennai urban population study-7 [CUPS- 7].
Glucose, Total cholesterol, HDL cholesterol, LDL
Indian J Med Res 2002;115:118-27.
cholesterol, Triglycerides, Uricacid Plasma
Abstract No: 10.28
CVD Risk Factors in Women with Subclinical Autoimmune Thyroiditis.
Sudheesh.M and T.Vijayakumar
Department of Biochemistry and Physiology, Educare Institute of Dental Sciences,Malapuram,
Kerala -675506, India.
Objective: Sub clinical hypothyroidism (SH),
defined as the clinical status of mildly elevated
serum TSH levels, is a far more common disorder
than overt hypothyroidism with a higher
prevalence among women and older subjects.
Certain studies have indicated that sub clinical
hypothyroidism has been associated with
increased risk of CAD, especially in women with
antibodies to thyroid peroxidase. Moreover, SH
impairs ventricular function as well as
cardiovascular and respiratory adaptation to effort
and, decreases heart rate variability impairs flowmediated vasodilatation, which is a marker of
endothelial function 1-3. The present study is an
effort to investigate the CVD risk profile in women
having autoimmune sub clinical hypothyroidism
with elevated Anti Thyroid Peroxidase
Antibodies.(Anti TPO Ab.)
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Methods: The study was carried out in blood
samples from 150 women in the age group of 35
to 50 who are suspected to have hypothyroidism
were included in the Case Group.80 apparently
healthy women in the age group of 35 to 50 with
normal serum TSH levels comprised the Control
Group. Blood / serum TSH, Free T3, Free T4,
Anti TPO Ab, Total Cholesterol, LDL cholesterol,
Triglycerides , Plasma fibrinogen and High
sensitivity C reactive protein
( hs-CRP) were
analyzed in both Case and Control Groups. The
data from the blood investigations were analyzed
statistically using Two Sample‘t’ test.
Results: All the blood / serum parameters which
were analyzed in our study were found to be
increased significantly in the Case Group when
compared to the Control Group (p < 0.001).
Conclusion: Thus the Case Control study in 200
women having sub clinical hypothyroidism with
elevated Anti Thyroid Peroxidase Antibodies
showed that they are at a higher risk for CVD than
their age-matched control counter parts.
References
1. Ross DS: Serum thyroid – stimulating hormone
measurement for assessment of thyroid function
and disease. Endocrinol Metab Clin North Am
2001, 30:245-264.
2. Walsh JP, Bremner AP, Bulsara MK, et al.
Subclinical thyroid dysfunction as a risk factor
for cardiovascular disease. Arch Intern Med
2005; 165:2467-2472.
3. Hak AE, Pols HA, Visser TJ, Drexhage HA,
Hofman A, Witteman JC. Subclinical
hypothyroidism is an independent risk factor for
atherosclerosis and myocardial infarction in
elderly women: the Rotterdam Study. Ann Intern
Med. 2000;132:270–278.
Abstract No: 11.1
Recurrent Aphhous Ulcer and Oral Lichen Planus: a Study of Patho-physiological
and Psychosomatic Significance of Salivary Nitric Oxide.
AB Agte* Bm Despande* Sm Dharwadkar** Kiran Jagtap* Sb Gaikwad*** and S.R.
Holkar****,
*SBM Dental College, Sangamner, Ahmednagar, **SB Science College, Aurangabad, *** SBH;
Government Medical College, Dhule, **** MGM Medical College, Aurangabad.
Objective: The aim of the present study was, to
study the role of Nitric Oxide in human saliva &
its diagnostic role in RAU & OLP, at outpatient
in SBM. Dental College & Hospital, Sangamner,
District Ahmednagar. Twenty (20) cases with
RAU, Fifteen (15) with OLP & Thirty (30) healthy
control individuals were included in the study. The
clinically diagnosed known cases of RAU & OLP
were included after taking detail case history. The
immunological imbalance & psychological stress
are considered to be the most prime factors for
the conditions like RAU & OLP. Further; the
Oxidative stress caused by Nitric Oxide has a
definite role in establishing the correlation
between [NO] with RAU & OLP.
274
Methods:: Under all aseptic precautions, fresh
saliva was collected in sterile plain bulb. The
sample was subjected to biochemical analysis of
Nitric Oxide (NO) by diazotization reaction with
adoption of the principles of Griess reagent. The
RAU cases were subdivided into major & minor
RAU & OLP cases were divided into erosive or
non erosive type after clinical & histological
examination.
Results: The salivary Nitric Oxide levels were
found to be increased significantly In RAU &
OLP group when compare with Control. Further
significantly increased levels have been observed
in OLP group when compared with RAU group
Indian Journal of Clinical Biochemistry Supplement, 2009/24
(P< 0.001). The Salivary Nitric Oxide levels were Conclusion: Thus these parameters can be treated
found to be increased significantly in minor RAU as a diagnostic tool for the differential diagnosis
than Major RAU & increase in erosive type of of RAU & OLP.
OLP than non erosive OLP.
Abstract No: 11.2
Oxidative Stress and Calcium Phosphorus Ratio in Rheumatoid Arthritis
Dr.A.Pullaiah*, and DR.N.Vani
*P.G.in Biochemistry; ** Professor&HOD, Dept of Biochemistry, Kakatiya Medical College,
Warangal-506007. Andhrapradesh.
Background: Rheumatoid arthritis is a common
debilitating, crippling disease with unknown
etiology associated with chronic inflammation and
bone resorption. Increased oxidative stress
contributes to the etiopathogenesis of R.A.
Objectives: Present study aims to determine the
oxidative injury by estimating the levels of
prooxidant Malondialdehyde and to study the role
of oxygen derived free radicals in R.A by assessing
the influence of disease process on serum calcium,
phosphorus, ALP levels in a view to study the
beneficial influence of adding free radical
scavengers to the existing therapeutic regimen.
Methods: The study was conducted on 50
clinically diagnosed cases of R.A who fulfill the
ARA criteria, compared with age & sex matched
controls with out systemic diseases like DM, HTN,
RF. Estimation of Malondialdehyde was done by
TBA assay, Calcium by O-CPC method,
Phosphorus by Fiske and Subbarao method, ALP
by King & Kind. Statistical analysis was done by
using student “t” test and p-value <0.05 were
considered as statistically significant.
Results: The results that were found are
statistically significant increase in serum MDA
levels (p<0.001), decrease in serum Calcium
(p<0.001), increase in serum Phosphorus (p<0.01),
decreased Ca,P ratio (p<0.001) and with no
statistically significant change in serum ALP levels
(p>0.05) in R.A patients as compared with control
group.
Conclusion: The observations in the present study
shows that oxidative stress plays an important role
in the etiopathogenesis of R.A and addition of free
radical scavengers as supplements may prove to
be beneficial. There is an altered Calcium and
Phosphorus metabolism and Ca,P ratio in R.A and
increase in MDA levels, an important marker.
Abstract No: 11.3
The Role of Oxidative Stress and Fibrinogen Level in Chronic in Diabetes Mellitus
Mrs. G. Ramani, Dr. Rita Mary Aruna, Dr. T. V. Mohan, and Mrs. G. Kavitha
VMKV Medical College, Salem.
Objective: Diabetes mellitus is a commonest
endocrine disorder which represents the serious
risk factor for the development of cardio vascular
diseases. Oxidative stress is a pathophysiological
state in which there is excess of Reactive Oxygen
Species. In diabetes mellitus oxidative stress
results from hyperglycemia. Oxidative stress alters
the plasma lipoprotein profile, the coagulative
parameters, the endothelium and the cell
membrane. Hence the present study was focused
to understand the total antioxidant level by Ferric
Reducing Antioxidant Antioxidant Power assay.
Methods: To conduct this study, blood samples
were collected from the thirty patients from the
Department of Medicine, Vinayaka Mission
Medical College, Salem. The level of total
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
antioxidant status was measured. The Lipid profile development of vascular disease. A negative
was studied along with the level of Fibrinogen. correlation by Pearson has been observed between
The results were compared with a control group. FBS and Ferric Reducing Antioxidant Antioxidant
Results: The present study has demonstrated a Power as well as HDL and Ferric Reducing
significant increase in FBS, PPBS, Total Antioxidant Antioxidant Power.
cholesterol, Triacylglycerols, very low density
cholesterol, low density cholesterol & Fibrinogen
levels and decrease in Total antioxidant level and
HDL in chronic diabetes mellitus patients. This
appears to be related to increased production of
lipid derived free radicals. Thus FBS oxidative
stress seems to play an important role in the
Conclusion: This is suggestive of increased FBS
as well as decreased HDL cause oxidative stress
which may lead to atherogenesis. Therefore, the
screening of diabetic patients in the initial stage
for abnormalities in lipid metabolism and oxidative
stress will be beneficial in the prevention of
diabetic vascular complications
Abstract No: 11.4
The Effect of Yoga Therapy on Antioxidant Level in Perimenopausal Women
1
Alok Kumar, 1Archana E.,1 Akshatha, 2Mrs. Gayathry Nayak, 1Dr.Revathi P. Shenoy and 1Dr.
Anjali Rao
1
Dept. Of Biochemistry, Kasturba Medical College, Manipal, India, 2Dept. Of Yoga Therapy, Kasturba
Medical College Hospital, Manipal, India; Email : [email protected]
Objective:: To assess the efficacy of yoga therapy
on antioxidant levels of perimenopausal women.
minutes/day). The total antioxidant (TA) levels in
serum were measured spectrophotometrically.
Methods: It is a prospective, non-randomized
control study. Consecutive sampling method was
used for the selection of perimenopausal women
aged between 40-60 years. There were yoga
(n=30) and control (n=30) groups. The yoga
intervention was on daily basis for 12 weeks (4550- minutes/day) and the control group
intervention was a set of standardised physical
exercises (15 minutes/day) and walking (20-25
Results: Total antioxidant levels are increased
significantly (p<0.025) after three months of
exercise and decreased significantly (p<0.048)
after three months of yoga. There is a significant
decrease in TA in post yoga group (p<0.001) as
compared to post exercise group (control).
Conclusion: There is a significant decrease in total
antioxidant levels after yoga intervention probably
due to increased consumption of TA to prevent
the oxidative stress when compared to exercise
group (control).
Abstract No: 11.5
Aluminum Induced Morphological and Biochemical Changes in Liver, Kidney and
Brain of Male Albino Rats; An Age Dependent Study
Anumesh Pathak1,2, Sandeep Tripathi1, A. K. Pathak2, Abbas Ali Mahdi1 , Sanjay Sen1,2 ,
Ramkrishan Ojha1,2 and Neelam Dubey1,2
1
Medical Elementology and Free Radical biology lab, Department of Biochemistry, C.S.M. Medical
University, Lucknow, 226003,2Department of Pharmacy, Barkatullah University, Bhopal, India
Objective: Substantial evidence supports the
hypothesis that aluminum (Al) is toxic for human
276
beings. To date, information on the interaction of
Al with oxidative stress parameters in the rat
Indian Journal of Clinical Biochemistry Supplement, 2009/24
organs in relation to age was limited and unclear. old rats but the retention was high in old than the
young rats. Oral administration of AlC3 increases
Methods: The purpose of the present study was Al, Fe, LPO, and GSSG and decreases SOD, CAT,
to investigate the effects of Al-induced toxicity GPx, GSH, and GSH/GSSG ratio, significantly
(100 mg/ kg b.w. AlCl3 orally for 90 days) on age (p<0.01) in comparison to control. No significant
(young and old) and organs (liver, kidney and (p>0.05) difference were observed in the activity
brain) of male albino rats. For this, selected of CAT and GPx and level of LPO, GSH, GSSG
oxidative stress biomarkers- lipid peroxidase and ratio of GSH/GSSG in the organs of young
(LPO), superoxide dismutase (SOD), catalase treated and old untreated rats suggests treatment
(CAT), glutathione peroxidase (GPx), reduced made young equivalent to old. Histopathological
glutathione (GSH) and oxidized glutathione and ultrastructural study also correlated with
(GSSG) along with metals- Al and Fe were biochemical findings.
investigated in the brain, kidney and liver of male
albino Wister rats. In addition, morphological Conclusion: These findings suggest that oral
(Histopathological and ultrastructure study) and administration of AlCl3 may produce pro-oxidant
Y maze test were also evaluated.
effect in rats and could be of interest for
understanding the controversial role of Al in
Results: Results show that the oral administration assessing toxicity and neurodegenerative diseases
of AlCl3 produce significantly (p<0.01) oxidative in exposed young and elderly population.
damage in liver, kidney and brain of young and
Abstract No: 11.6
Reduced Nitric Oxide Synthesis in Pre-eclampsia: Role of Inflammatory Cytokines
and eNOS Gene Polymorphism
Archana Singh. 1, Deepika Sharma.1, Chitra Raghunandan.2 and Jayashree Bhattacharjee.1
1-Deptt. of Biochemistry, 2- Deptt. Of Obstetrics and Gynecology, Lady Hardinge Medical College,
New Delhi, India.Email: [email protected]
Background: Pre-eclampsia is associated with
nitric oxide dysfunction. In order to gain more
insight into the mechanisms underlying pre-eclampsia, we evaluated the effect of endothelial
nitric oxide synthase Glu298Asp gene polymorphism and inflammatory cytokines on levels of
serum NO in pre-eclamptic pregnant women.
Results: Pre-eclamptic group showed significantly
decreased serum NO levels whereas TNFá, IL-6,
IL-2and ET-1 were increased significantly. No
significant differences were found in genotype/allele distribution among the two groups. A significant negative correlation was seen between NO
and IL-6 in pre-eclamptic group. Levels of NO
were found to be decreased in women with GT
Methods: This cross-sectional study included 50
genotype whereas levels of IL-6 were found to be
pregnant women diagnosed with Pre-eclampsia
increased in the same.
and 50 healthy pregnant women. Their blood
samples were analyzed for NO, TNF á , IL -6 , Conclusion: Pre-eclampsia occurs when there is
IL-2 and Endothelin-1 and eNOS gene polymor- failure of compensatory response in terms of dephism.
creased vasodilatation. NO, a potent vasodilator
277
Indian Journal of Clinical Biochemistry Supplement, 2009/24
is decreased in pre-eclampsia. Increased IL-6, contributes to increased vascular resistance by inhibiting endothelium dependent NO-cyclic guanine
monophosphate mediated relaxation pathway in
systemic vessels in pre-eclampsia. In the present
study no significant association was found be-
tween Glu298Asp polymorphism and pre-eclampsia. However, this polymorphism decreases NO
levels, and women with this polymorphism might
develop CAD later in life. Much larger studies are
needed to confirm or refute a realistic genotypic
risk of disease.
Abstract No: 11.7
Liver Function and Total Antioxidant Capacity in Hypothyroidism
Bhawna Bhimte*, Dr.B.K.Agrawal*, Dr.V.K.Sharma** and Prashant Nigam*
*Department of Medical Biochemistry, Gandhi Medical College, Bhopal, **Department of Medicine,
Gandhi Medical College, Bhopal . Email: [email protected]
Objective: Thyroid hormone plays important role
in normal hepatic function. Hypothyroidism may
perturb normal metabolic function of liver. Low
activity of thyroid hormones may also be
associated with oxidative stress causing decrease
antioxidant capacity.
Methods: Prospective study has been done to
assess liver function and total antioxidant capacity
in 100 hypothyroid patients compared to healthy
controls. Following parameters has been measured
at the time of detection & then after 6 weeks. TSH:
Competitive Solid Phase Enzyme Immunoassay
Alkaline Phosphatase: p-nitrophenyl phosphate
Gamma Glutamyl Transferase: End point pnitroaniline method Total Antioxidant Capacity:
Korvacevic method.
Results: TSH level of hypothyroid patients were
found to be increased significantly at the time of
detection when compared to controls (P<0.001),
but values were found to be reduced after 6 weeks
of therapy. Activity of both liver enzymes ALP,
GGT were found to be reduced in hypothyroid
patients at the time of detection, but after 6weeks
of therapy values of ALP & GGT were improved.
(P<0.05). Total Antioxidant Capacity were also
reduced in hypothyroid patients, that was found
to be improved after six weeks of therapy
(P<0.001).
Conclusion: From above results it may be
concluded that hypothyroidism modulate normal
liver function, thus interfering with the liver
enzyme production or probably its activity.
Increased TSH may stimulate excess oxidative
stress, thus creating load on Antioxidant Capacity.
Abstract No: 11.8
A Study on Free Radical Activity in Burns
Dr. Bikash Kr. Chaudhury and Dr. Runi Devi
Gauhati Medical College & Hospital, Guwahati-781032, NEIGRIHMS, Shillong-793018
Email: - [email protected]
Objectives: The metabolic response to thermal sustained injury is mediated not by the burns itself,
injury is similar to the metabolic response to stress but by the ROS generated secondarily. The study
following trauma and about two-thirds of the was undertaken assess free radical activity in burn
278
Indian Journal of Clinical Biochemistry Supplement, 2009/24
cases, to correlate free radical activity with extent Results: In the test subjects serum MDA and serum
and depth of burn injury and to utilize data for Uric acid was significantly raised whereas serum
better management of burn patients.
TIBC, blood Glutathione Peroxidase and
Superoxide dismutase levels were significantly
Methods: 35 cases of burn injuries admitted to depleted compared to the controls establishing the
Gauhati Medical College and Hospital, Guwahati relation that oxidative stress is associated with
and 35 healthy individuals, age and gender increased burn trauma severity resulting in
matched for the patients were studied. antioxidant depletion, strong oxidant production
Malondialdehyde, Superoxide Dismutase, and cellular damage.
Glutathione Peroxidase, Uric acid and Total Iron
Binding Capacity (TIBC) were using a Conclusion: The study demonstrates the
colorimeter, a semi automated analyzer relationship between a lipid peroxide reaction and
(Humanlyser 2000) and the fully automated Dade secondary pathological changes following burns.
Behring AR series. Statistical analysis was done Therefore early introduction of prophylactic
AnalystSoft, StatPlus statistical analysis program antioxidant therapy may be beneficial following
Version 2006. The results were taken as significant trauma and is highly recommended.
when the ‘p’ value < 0.05.
Abstract No: 11.9
Oxidative Stress in N-acetylcysteine Treated Off Pump CABG Surgery Patient
Shyama Subramaniam, S.Subramaniam, K.Dhanajayan, K.Ezhilarasan, K.Baskar* and
B.Jalakandan*
Department of Biochemistry, Apollo Hospitals, Chennai – 600 006.
*Department of Anesthesiology, Apollo Hospitals, Chennai – 600 006.
Objective: To compare the effect of Nacetylcysteine (NAC) on off-pump CABG induced oxidative stress by analyzing the plasma
malonedialdehyde (MDA) and glutathione levels.
Results: A marked reduction of GSH and significant elevation of MDA were noticed after surgery
in off pump CABG patients (P<0.001) . Pre operative treatment of NAC increased the GSH level
and reduces the MDA level.
Methods: Plasma malonedialdehyde (MDA) and
glutathione (GSH) were analysed in blood samples Conclusion: Off pump CABG operation increases
obtained from 50 patients undergoing CABG, pre- the oxidative stress but NAC treatment reduces the
operatively and after surgery. The patients were oxidative stress by increasing GSH level.
divided into two groups with and with out NAC
treated patients.
Abstract No: 11.10
Estimation of Lipid Profile, Vitamin E and Malondialdehyde, in Pre-eclampsia
*Dr Chandan Kumar Nath and Dr Upasana Baruah
*Senior Resident, Department of Biochemistry, NEIGRIHMS, Shillong-18; E [email protected],
Objective: The present study was undertaken to evaluate the metabolic correlation between
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
preeclampsia and oxidative stress.
Methods: We selected 95 no of subjects for the
study out of which normal nonpregnant control
group had 25 subjects, normal pregnant control
group had 40 subjects & preeclampsia group
constituted of 30 subjects. The investigations
included are serum lipid profile consisting of serum
total cholesterol, serum triglycerides, VLDL, LDL
and HDL, serum vitamin E as á- tocopherol and
malondialdehyde.
Results: There is significant increase in serum
triglyceride, serum cholesterol along with LDL and
VLDL (p<0.0001) in pregnancy over nonpregnant
controls and preeclampsia over pregnant control
(p<0.0001). It is observed that in normal controls
without pregnancy there is no relationship between
serum vitamin E and serum lipid peroxidation as
represented by whole blood MDA
(malondialdehyde) with a correlation coefficient
of 0.13 only. In contrast to this, under the condition
of normal pregnancy and preeclampsia the
correlation between these two parameters
increased with coefficients of correlation (r = - 0.9)
with a negative trend indicating a definite and
significant degree of inverse relationship between
two.
Conclusion: It is finally proposed that adequate
vitamin E supplementation during pregnancy with
proportionate increase in preeclampsia may reduce
the consequences of peroxidation induced
complications during pregnancy.
Abstract No: 11.11
Antioxidant Status in Goats During Pregnancy
Cynthia Jose* and K.K. Jayavardhanan**
* MVSc Scholar, ** Associate Professor, Department of Veterinary Biochemistry, College of Veterinary
and Animal Sciences, Mannuthy, Thrissur- Pin 680651 [email protected]
Objective: Production of free radicals is a
physiological phenomenon which occurs
continuously in the body during metabolism and
body usually has sufficient antioxidant reserves
to cope with its production. However, when free
radical generation exceeds the body’s anti-oxidant
production capacity, oxidative stress develops.
The aim of the present study was to evaluate under
field condition the oxidative status in healthy goats
during pregnancy on the basis of 3 parameters:
plasma levels of malondialdehyde (MDA),
reduced glutathione (GSH) and glutathione
peroxidase (GSH-px). In order to evaluate
metabolic homeostasis, common metabolic
parameters (glucose, total protein, albumin,
cholesterol, urea and creatinine) were determined
as well.
Methods: The study was carried out using 15
healthy female cross bred goats maintained at
280
Kerala Agricultural University Goat Farm,
Mannuthy. Blood samples were collected 4 times:
before pregnancy, at 2 nd and 4 th months of
pregnancy and one week before kidding. The
values obtained during pregnancy were compared
with those obtained in the same animals before
pregnancy.
Results: The study showed that the lipid
peroxidation was increased in the pregnancy
period as revealed by an increase in MDA level.
Significant higher MDA level was observed in the
4th month of pregnancy. This suggested that after
the middle gestation period, the body presents high
levels of free radicals which cause lipid
peroxidation. The activity of anti-oxidant enzyme,
GSH-px and the level of GSH were also found
increased in this period, providing protection to
the fetus against the negative influence of free
radicals. The serum glucose concentration was
Indian Journal of Clinical Biochemistry Supplement, 2009/24
significantly lower in the 4th month of pregnancy,
indicating low energy balance in this period. The
cholesterol and creatinine concentrations were
higher in pregnant goats with a peak level in the
late pregnancy period.
Conclusion: The data suggest that the
antioxidative/prooxidative status is associated with
the metabolic adaptations to low energy balance,
which occur during pregnancy.
Abstract No: 11.12
Comparative Study of Lipid Peroxidation and Non-enzymatic Antioxidant
Vitamin E and Vitamin C in Plasmodium Vivax and Falciparum Malaria in
Western Rajasthan with special reference to Bikaner District.
R.K. Vyas, D. Yadav, M.L. Sharma, Y. Soni and D. Nandini
Department of Biochemistry S.P. Medical College, Bikaner (Rajasthan)
Objectives: - Oxidative stress and changes in
antioxidant status have been implicated in the
pathogenesis of malaria. Bikaner district, being a
part of Thar desert due to extremes of temperature
has always been regarded as hypoendemic region
for malaria but in recent years prevalence of
Malaria has increased in this region due to changes
in Ecosystem contributed by increased rainfall and
Canal Irrigation. So this study was conducted in
patients with Plasmodium falciparum and
Plasmodium vivax malaria to evaluate status of
lipid peroxidation and effect on vitamin E and C
level.
Methods: - In study we included 100patients out
of which 50were suffering from Plasmodium vivex
Malaria and other 50with Plasmodium falciparum
Malaria. Plasma Thiobarbituric acid reactive
substances(TBARS) were measured using Buege
& Aust’s Method(1978) to assess the degree of
lipid peroxidation and antioxidant status was
measured by estimating the level of Vit E&C
using Baker & Frank’s Method(1976) using
Bipyridyl reagent and Roe & Kuethe’s Method
using 2.4DNPH respectively. Results were
compared with age and sex matched control
subjects(n=50).
Results: Our study demonstrates that level of
oxidative stress was significantly increased
(P<.001) while antioxidant vitamins E&C were
significantly decreased (P<.001) in both the groups
of malaria. Plasmodium falciparum (2.82+ 1.06
nmol/ ml) malaria showed significantly increased
(P<.001) level of Malondialdehyde when
compared to Plasmodium vivax malaria (1.72+
0.70nmol/ml). Maximum decline in Vit C level
(p<.001) were observed in plasmodium vivax
malaria while maximum decline in Vit E level
(p<.001) were observed in Plasmodium falciparum
malaria. Therefore it has been hypothesized that
the oxidative stress induced by malaria can be,
combated by augmentation of Vit E&C.
Abstract No: 11.13
Comparative Study of Serum Myeloperoxidase Level and Lipid Profile in
Healthy Individuals
Suchetha Kumari. N* and Ramitha K**
* Professor, Dept. of Biochemistry, K.S Hedge Medical Academy, Deralakatte, Mangalore -575018,
** Research Assistant, Central Research Lab, A.B.S.M.I.D.S Deralakatte, Mangalore -575018, Email: [email protected]
Background : Myeloperoxidase (MPO) is an iron-
containing heme protein, plays an important role
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
in host defense. It is one of the enzymes of the
innate immune system, which acts as a potential
marker of cardiovascular disease and potential
target for treatment. Myeloperoxidase oxidizes
LDL rendering it atherogenic, as well as oxidative
modification of apolipoprotein.
spectrophotometric method. The subjects were
grouped into low lipid profile subjects and high
lipid profile subjects based on their cholesterol
level. The data were analyzed for statistical
significance by one way ANOVA and P<0.05 was
considered as the level of significance.
Objective: The present study was designed to
compare the serum myeloperoxidase level and
lipid profile in healthy individuals.
Results: Myeloperoxidase levels were positively
correlated with cholesterol, LDL, and Triglycerol
levels in both high and low lipid profile subjects.
But, HDL has shown a negative correlation with
the Myeloperoxidase level.
Methods: This study was carried out at K.S.Hegde
Medical College Hospital. Fifty volunteers of age
between 30-40 yrs were selected for the study.
About 5 ml of overnight fasting blood was
collected and used for the estimation of lipid
profile and Myeloperoxidase levels by
Conclusion: In this study we observed that
individuals with high lipid profiles showed an
increased Myeloperoxidase activity, which might
be due to peroxide ions of lipids.
Abstract No: 11.14
Nitric Oxide and Lipid Profile in Type 2 Diabetes Mellitus— A Case Control Study
in East Sikkim
Dr A Ghosh, Ms Y Bhutia, Dr T A Sing and Dr M L Sherpa
Department of Biochemistry, Sikkim Manipal Institute of Medical Sciences, 5th Mile Tadong, Sikkim737102; Email- [email protected]
Objective: Diabetes Mellitus has reached
epidemic proportions with an alarming rise in the
Asian countries including India. This particular
study has been taken up to compare the serum
NO level in patients with diabetes and healthy
controls and to establish correlation between
serum nitric oxide level and diabetes mellitus in
Sikkim.
Methods: Lipid Profile and serum nitrite were
assayed in 52 subjects, 26 of which were
diagnosed cases of type II Diabetes Mellitus
undergoing treatment in SMIMS and 26 were
healthy volunteers. The statistical analysis was
done using SPSS 17 and the comparison between
cases and control was calculated by Student’s t –test.
282
Results: Most of the patients were above 40 years
of age. Mean serum nitrite was lower in diabetics
in comparison to non-diabetics but the difference
was insignificant (p=0.141). Triacylglyerol, LDL
were markedly raised in Diabetics but statistically
insignificant (p=0.08), (p=0.55). HDL was
significantly lower in Diabetics in comparison to
non diabetics (p=0.001). Total Cholesterol was
markedly lower in diabetics but this difference was
statistically insignificant.
Conclusion: The pattern of findings in our studies
is consistent with the findings elsewhere but not
statistically significant. This could be due to the
duration of diabetes and the role of drugs, dietary
and lifestyle modification prior to the study.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 11.15
MDA, Antioxidant Enzymes, their Correlation in Normotensive and Pre-eclamptic
Maternal and Cord Blood
Mohd Suhail1, Safia Suhail2 , Bharat Kumar Gupta3 and Vinay Bharat4
1. Department of Biochemistry, University of Allahabad, Allahabad-211002, India., 2. City Nursing &
Maternity Home Research Center, 21, Minhajpur, Allahabad- 211003, India., 3. Professor and Head,
Department of Biochemistry & Immunology, Subharti Medical College, S. V. S. University, Meerut250005, India, 4. Associate Professor, Department of Pathology, Subharti Medical College, S. V. S.
University, Meerut- 250005, India Email: [email protected]
Objective: We evaluated, if cord blood of pregnant
women with oxygen radical disease had different
total enzymatic antioxidant status than those
without preeclampsia (PE).
Methods: Blood from 23 normotensive (control)
and 23 preeclamptic mothers was tested for
Malondialdehyde (MDA); and antioxidant
enzymes, Superoxide dismutase (SOD);
Glutathione Peroxidase (GPx) and Catalase
activity and results were compared for oxidative
and anti-oxidative system in maternal and cord
blood of pair-matched mother and neonate.
Results: MDA in preeclamptic maternal plasma
was significantly high (p < 0.001) as compared to
control. Interestingly, its content in preeclamptic
cord blood was significantly low (p < 0.001)
compared to their pair-matched maternal blood.
SOD activity was 8.7% higher in cord as compared
to pair-matched normotensive maternal blood
which was significant (p=0.01) whereas in
preeclamptic cord the level decreased significantly
(p=0.011) in comparison to pair-matched
preeclamptic maternal. GPx was 16.4% higher in
normotensive cord compared to maternal blood
and 7% low in preeclamptic cord compared to pairmatched maternal blood. The increase was
significant (P=0.011) in normotensive cord
whereas in preeclamptic cord the decrease was
insignificant (p=0.06). Catalase activity showed
20.97% elevation in normotensive and 16.12%
increase in the preeclamptic cord blood compared
to their pair-matched maternal blood. This was
significant with p=0.01 and p=0.017 in control and
preeclamptic group respectively.
Conclusion: we found that the oxidative stress is
low in the blood of neonates born to preeclamptic
mothers. Further studies are needed to explore
strategies so that the normal levels of antioxidant
are maintained to combat preeclampsia in high risk
patients.
Abstract No: 11.16
Superoxide Dismutase Activity in Ridley-Jopling Leprosy Types
CVB Prasad and MV Kodliwadmath
Department of Biochemistry, J. N. Medical College,
Belgaum- 590 010, Karnataka, India. E mail: [email protected]
Objective: Oxidative stress has been reported in (SOD) activity in Ridley-Jopling leprosy types.
leprosy due to poor immunity and malnutrition.
Methods: Hundred patients of leprosy comprising
The objective of the present study was to
22 Tuberculoid leprosy (TT), 28 Borderline
investigate the erythrocyte superoxide dismutase
tuberculoid leprosy (BT), 13 Borderline leprosy
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
(BB), 16 Borderline lepromatous leprosy (BL) and
21 Lepromatous leprosy (LL) were studied along
with 50 normal healthy controls.
enzyme activity was detected along the leprosy
spectrum from TT to LL.
Conclusion: The findings suggest diminution of
Results: The enzyme activity was found to be SOD activity leading to impaired antioxidant
significantly low in leprosy (total patients) as potential in leprosy patients
compared to controls. A progressive decline in
Abstract No: 11.17
Effect of Wheat Grass on Oxidative Stress in High Fat Diet induced
Hyperlipidemia in Rabbits
Dr. Kiran Dahiya*, Dr. Veena Singh*, Dr. Sangeeta B.Singh*, Dr. Jyoti Sethi#, Dr. Mridul Yadav#
and Prashanta Saha Roy*.
*Department of Biochemistry, # Department of Physiology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana,
India. Email ID: [email protected]
Results: High fat diet was found to produce
hyperlipidemia and an increase in oxidative stress
as indicated by a significant rise in
malondialdehyde levels while antioxidants like
glutathione and vitamin C were found to be
reduced significantly. Wheatgrass supplementation along with high fat diet produced an
improvement in lipids (total cholesterol decreased
and HDL-C increased) while significantly
reducing MDA levels. A significant increase was
observed in reduced glutathione and vitamin C
Methods: Thirty rabbits were divided in three levels.
groups of ten rabbits each, group I received control
diet, group II high fat diet & group III both high Conclusion: Thus wheat grass can act as an
fat diet and wheat grass for a period of ten weeks. antioxidant booster and may have a beneficial role
The fasting serum samples were analyzed for total in ameliorating hyperlipidemia and associated
cholesterol, HDL-cholesterol, malondialdehyde, oxidative stress.
reduced glutathione and vitamin C and compared
statistically between the groups.
Objective: Hyperlipidemia is a commonly
encountered health problem. A number of
medicinal plants are found effective in treating
hyperlipidemia besides the drug therapy. Wheat
grass (Triticum aestivium)is used as a general
health tonic and has been reported to be effective
in some medical disorders though much literature
is not yet available. So this study was planned to
observe the effect of wheat grass on high fat diet
induced hyperlipidemia in rabbits.
bstract No: 11.18
Study of Lipid Peroxidation and Anti Oxidant Status in Pre-Eclampsia
Dr.Rajni S* , Dr. S.S. Halyal** and Dr.Jayaprakash Murthy D.S **
*Assistant Professor; **Professor; Department of Biochemistry, J.J.M.Medical College,
Davangere , Karnataka [email protected]
Background: Pre-eclampsia is a multiorgan
disorder characterized by hypertension and
284
proteinuria and a complication of pregnancy
affecting 2-4% of all pregnancies. Multiple factors,
Indian Journal of Clinical Biochemistry Supplement, 2009/24
including increased oxidative stress and decreased method. The data was then statistically analyzed
antioxidant capacity have been associated with using students’t test (unpaired).
pre-eclampsia.
Results: The results revealed that pre-eclamptic
Objective: The purpose of this study is to evaluate patients had significant increase in serum
oxidative stress in pre-eclampsia by estimating malondialdehyde and decrease in serum vitamin
E,superoxide dismutase and erythrocyte reduced
serum pro-oxidants and antioxidants.
glutathione levels when compared to healthy
Methods: The present study included one hundred controls, and these results were more pronounced
and ten women, among them forty were healthy in severe pre-eclampsia when compared to mild
controls and seventy were clinically diagnosed pre-eclamptic patients.
pre-eclamptic cases who were divided into mild
and severe pre-eclamptic cases.The samples were Conclusion: The study concludes that the severity
estimated for serum Malondialdehyde by of pre-eclampsia is closely related to the degree of
thiobarbituric acid method, serum Vitamin E by oxidative stress. This study suggests that a regular
Baker and frank method, serum Superoxide evaluation of oxidant and antioxidant status could
dismutase by marklund and marklund method and provide an early predictive index of risk factors
erythrocyte Reduced glutathione by Beutler et al and further intervention to prevent pre-eclampsia.
Abstract No: 11.19
Attenuation of Inflammation and Oxidative Stress by Plumbago capensis in Freund’s
Complete Adjuvant-Induced Arthritis in Rats
A.I.Charles Dorni2 , Hannah R. Vasanthi1, K.S Jayachandran2.. and G.V.Rajamanickam2
1
Dept of Biochemistry, Sri Ramachandra Medical College, Sri Ramachandra University, Porur, Chennai,
India, 2Centre for Advanced Research in Indian System of Medicine(CARISM), SASTRA University,
Thanjavur, India
Objective: Oxygen derived free radicals and their
products are known to play an important role in
the pathogenesis of chronic inflammatory
disorders such as rheumatoid arthritis. The
purpose of this study was to investigate the antiinflammatory and anti-oxidant effects of alcoholic
extract of Plumbago capensis (PC) in adjuvant
induced arthritis in rats.
glutathione peroxidase and an increase in the lipid
peroxidation as indicated by the higher levels of
thiobarbituric acid reactive substances (TBARSs).
Daily treatment of rats with PC (250 mg/kg) and
standard anti-inflammatory drug indomethacin
(10mg/kg) for 45 days produced a significant
attenuation in the inflammatory response and
ameliorated the arthritic changes in the joint. The
protection afforded by Plumbago capensis (PC)
was more pronounced than that of indomethacin
and was associated with normalization of the levels
of inflammatory mediators and biochemical
parameters of oxidative stress.
Methods: Intra-articular injection of FCA
produced inflammation of the joint with a peak
effect occurring on day 4 where a maximum
increase in the levels of paw edema and
inflammatory mediators like PGE2, IL2 and IL6
was observed.
Conclusion: The pharmacological potential
exhibited by the plant drug is probably mediated
Results: This was associated with oxidative stress through the phyto-constituents such as flavonoids
with a marked reduction in the levels of in the extract which was also confirmed through
glutathione, catalase, superoxide dismutase and in-silico analysis.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 11.20
Effect of Vitamin E Supplement on Blood Anti-oxidant Status in Cigarette Smokers.
Juhi Aggarwal and Sadhana Sharma
Santosh Medical College and Hospital, Santosh University, Ghaziabad-201009, India
Background: Coronary Heart Disease (CHD) is
a major cause of mortality worldwide and smokers
are at high risk of developing CHD. Reactive free
radicals are associated with the formation of
atheromatous plaques. Cigarette smoke contains
free radicals which initiate and propagate the
process of lipid peroxidation.Present study aims
to assess indices of free radical mediated
peroxidation in smokers and non smokers along
with the effect of vitamin E supplementation.
Methods: Two experiments were designed for the
study comprising age group of 30-45 years. Exp.1
has 10 male smokers and 10 non smokers. Plasma
and erythrocyte antioxidants and antioxidant
enzyme status were measured. Exp. 2 included 20
male smokers and 20 non smokers and each given
a placebo followed by vitamin E (1000 mg αtocopherol acetate) for 14 days. Plasma indices of
lipid peroxidation were measured.
Results: For Exp. 1 plasma concentration of
vitamin E were decreased (p < 0.04) in smokers.
Plasma ascorbic acid concentration was 50% lower
in smokers but dehydroascorbic acid concentration
was raised (p < 0.06) in them. Erythrocyte glucose
-6 phosphate dehydrogenase and glutathione
peroxidase levels were significantly lower (p <
0.05 and p < 0.02 respectively) in smokers. For
Exp.2 In smokers, the elevated erythrocyte lipid
peroxidation (p< 0.01) was abolished by vitamin
E supplementation (p < 0.05) and conjugated diene
levels were raised significantly (p < 0.04).
Conclusion: Hence it is evident that free radicals
involved in cigarette smoke contribute to the
pathogenesis of CHD and increased antioxidant
intake inhibits the formation of atheroma.
Abstract No: 11.21
Oxidative Stress and Antioxidant Therapy in Nephrotic Syndrome
Jyoti Dwivedi 1 and Dr.Purnima Dey Sarkar 2
Deptt. of Biochemistry, S.S. Medical College Rewa (M.P.) 486001 India, 2 Deptt. of Biochemistry,
N.S.C.B. Medical College Jabalpur (M.P.) India.
1
Objective: The free radicals have a negative
influence on renal tissue in nephrotic syndrome.
Nephrotic syndrome is a consequence of an
imbalance
oxidant/antioxidant
status.
Hyperhomocyst(e)inemia induce oxidative
modification in nephrotic syndrome. Zinc and
copper deficiency in nephrotic syndrome related
to increase urinary zinc and copper losses. The
aim of the present study was to estimate the serum
total antioxidant capacity, malondialdehyde,
homocysteine, copper, zinc, plasma vitamin C
during remission and complication.
286
Methods: The present study was conducted on 3
groups, group1 comprised of 50 pretreated
nephrotic syndrome patients, group 2 comprised
of 50 post treated nephrotic syndrome patients and
group 3 comprised of 41 secondary nephrotic
syndrome patients. Serum total antioxidant
capacity, malondialdehyde, homocysteine, copper,
zinc, plasma vitamin C were analyzed.
Results: In the present study observed there were
significant decreased level of serum total
antioxidant capacity, copper, zinc, plasma vitamin
Indian Journal of Clinical Biochemistry Supplement, 2009/24
C and increased serum level of malondialdehyde,
homocysteine, in group 3 when compared group1.
However
significant
reduction
in
malondialdehyde, homocysteine and significant
improvement in serum total antioxidant capacity,
copper, zinc & plasma vitamin C were observed
after antioxidant, minerals & B-complex therapy
with routine prescription in group 2 when
compared to group 1.
Conclusion: In the present study oxidative stress
is higher in secondary nephrotic syndrome than
nephrotic syndrome. The study further reports
beneficial effects of antioxidants, minerals and Bcomplex vitamins on oxidative stress in nephrotic
syndrome patients may prolong need for treatment
of nephrotic syndrome and secondary nephrotic
syndrome patients.
Abstract No: 11.22
Antioxidant Status in Patients with Uncomplicated Type 2 Diabetes Mellitus
K. Sowmya1, S.Thanikachalam2 and Satyajeet Giri2
1-Department of Biochemistry, 2- Department of cardiology, Sri Ramachandra Medical College and
Research Institute, Chennai- 6000116,India. Email:[email protected]
Background: In the past few decades, type 2
diabetes mellitus (T2DM) has rapidly increased
worldwide. Persistent hyperglycemia leads to
increased generation of reactive oxygen species,
as a result the antioxidant capacity is expected to
be decreased in diabetic patients.
hemolysate for SOD were used. Plasma glucose,
lipid profile and uric acid were analyzed in
Dimension RxL autoanalyzer using kits supplied
by Siemens Dimension. HbA1c was analyzed by
Biorad D-10. SOD was analyzed in Hitachi U-2001
spectrophotometer .TAS was analyzed in Konelab
60i autoanalyzer using kits supplied by Randox .
Objective: Hence this study was taken up to Statistical analysis was done using students t- test.
compare the levels of plasma total antioxidant P < 0.05 was considered significant.
status (TAS), uric acid and superoxide dismutase
(SOD) of T2DM patients with healthy individuals Results: Significant dyslipidemia & elevated
along with routine plasma fasting & postprandial plasma glucose levels were seen among the T2DM
glucose, HbA1c and lipid profile.
cases. The levels of TAS & SOD were significantly
decreased in cases compared to the normal group
Methods: The study group comprised of 50 and uric acid levels were found to be slightly
healthy individuals as controls and age matched elevated among cases.
35 uncomplicated Type2 diabetes mellitus patients
as cases. Samples were collected using BD Conclusion: Our study finding shows reduced
Vacutainer tubes. Fluoride plasma for glucose, antioxidant activity among patients with Type2
heparinized plasma for TAS, EDTA whole blood diabetes mellitus. Hence they are prone for
for HbA1c, serum for uric acid & lipid profile and oxidative damage due to increased oxidative stress.
Abstract No: 11.23
Chronomics of Oxidants, Anti-oxidant Enzymes and Related Molecules in
Gyenecological Malignancies
R K Singh, S Singh, R Singh, S Pandey, S Mehrotra, U Singh, O Schwartzkopff, G Cornelissen
and F Halberg
Departments of Biochemistry and Obstetrics & Gynecology, C S M Medical University and Halberg
Chronobiology Center, University Of Minnesota, Minneapolis, MN, USA.
287
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Background: Chronomics ( an outgrowth of
chronobiology, the study of diversity in time ), is
the inferential statistical mapping, “imaging’’ of
time structures in variables in and around us,
consisting of rhythms, chaos and trends i.e., of
the chronome. The chronome ( from chronos,
time, and nomos, rule; time structure ) of oxidants
and anti-oxidant defense mechanisms may relate
to
prevention
and
curative
chronochemotherapeutic efficacy and
management.
Methods: Forty newly diagnosed women with
gyenecological malignancies, 30-60 years of age,
and 30 age-matched clinically healthy women
were synchronized for 1 week with diurnal activity
from about 06:00 to about 22:00 and nocturnal
rest. Breakfast was around 08:30, lunch around
13:30 and dinner around 20:30. Drugs known to
affect the free-radical system were not taken.
Blood samples were collected at 6-h intervals for
24 hour under standardized conditions. Plasma
malondialdehyde
(MDA), total lipid
hydroperoxide (LOOH), protein carbonyl (PC),
superoxide dismutase (SOD), catalase (CAT),
glutathione peroxidase (GPx), glutathione
reductase (GR) activities, and serum ascorbate,
urate and high-density lipoprotein cholesterol
(HDL-C) concentrations and urinary MDA and
Melatonin were also determined.
Results: A marked circadian variation was
demonstrated for each variable in each group by
population-mean cosinor (p < 0.01). In addition
to anticipated differences in overall mean value
(MESOR), patients differed from healthy
volunteers also in terms of their circadian pattern.
Conclusion: Mapping the broader time structure
(Chronome) with age and multifrequency rhythm
characteristics of anti-oxidants and pro-oxidants
is needed for exploring their putative
chemotherapeutic role as markers in cancer
chronoprevention and management of
gyenecological malignancies.
Abstract No: 11.24
Seminal Malondialdehyde, Nitric Oxide, Zinc and Superoxide Dismutase Activity
in Male Infertility
Kavita More*, Prof P G Samant** and Dr Z G Badade***
*Lecturer, **Professor, ***Professor& Head, Department of Biochemistry, MGM Medical College,
Kamothe, Navi-Mumbai, Pin-410 209: [email protected]
Objective: The aim of our study was to determine
the levels of malondialdehyde (MDA), nitric
oxide, zinc and superoxide dismutase (SOD)
activity in seminal plasma and to find out their
correlation with semen parameters.
Methods: The material represents 60 semen
samples, which were divided into two groups:
Group I-Normospermic (n=30), Group IIOligospermic (n=30). Seminal plasma
malondialdehyde, nitric oxide, zinc and SOD were
estimated by spectrophotometric methods. The
study includes determination of selected semen
parameters.
288
Results: Seminal plasma malondialdehyde and
nitric oxide were high in oligospermic than
normospermic. Seminal plasma zinc and SOD
were low in oligospermic than normospermic.
There was a negative correlation between
malondialdehyde and nitric oxide with zinc and
SOD in oligospermic. Seminal plasma
malondialdehyde and nitric oxide showed a
negative correlation with sperm count and sperm
motility. Seminal plasma zinc and SOD showed a
positive correlation with sperm count and sperm
motility in oligospermic group.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Conclusion: The increase in malondialdehyde,
nitric oxide and decrease in zinc and superoxide
dismutase levels in oligospermic may cause
disruption in the membrane integrity of
spermatozoa and may have role in reduction of
sperm DNA integrity. There was a positive
correlation between zinc and SOD with sperm
count and sperm motility, indicating zinc may play
an important role in spermatogenesis and
steriodogenesis. Thus estimation of seminal
malondialdehyde, nitric oxide, zinc, and SOD can
be useful tools for determining sperm fertilization
potential. These parameters could assist in
diagnosis of male infertility and help in treatment
of infertile male.
Abstract No: 11.25
Study of Nitrate + Nitrite and Antioxidant Enzyme Levels in Oral Cancer
Kinjal R. Patel, Jayendra B. Patel, Shruti R. Patel, Shilin N. Shukla and Prabhudas S. Patel
Biochemistry Research Division, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad 380 016, Gujarat E mail: [email protected]
activities of erythrocyte SOD and catalase were
higher in WHT than NHT. Erythrocyte SOD and
catalase levels were higher in WHT and patients
with OPC as compared to NHT. The erythrocyte
SOD and catalase activities were lower in oral
cancer patients than patients with OPC. The
erythrocyte SOD activity was higher in advanced
oral cancer than the early disease. Erythrocyte
catalase activity was lower in poorly differentiated
tumours than well and moderately differentiated
Methods: Blood samples were collected from
tumours. Person’s correlation analysis revealed that
the subjects. NO 2 +NO 3 (nitrite+nitrate) ,
alterations in plasma NO 2+NO 3 levels were
superoxide dismutase (SOD) and catalase levels
negatively associated with changes in erythrocyte
were estimated by highly specific
SOD activities.
spectrophotometeric methods. Statistical analysis
was done by SPSS statistical software version 11. Conclusion: The data revealed that the alterations
in antioxidant activities were associated with
Results: Mean plasma NO2+NO3 levels were
production of nitric oxide in oral cancer, which
elevated in patients with OPC and oral cancer
may have significant role in oral carcinogenesis.
patients as compared to the controls. Mean
Background: Oral cancer is the leading
malignancy in India. Nitric oxide and antioxidant
enzymes play an important role in etiology of oral
cancer. Therefore, the present study evaluated
nitric oxide and antioxidant enzyme levels in
healthy individual without tobacco habits (NHT,
N=30) and healthy individuals with tobacco habits
(WHT, n=90), patients with oral precancers (OPC,
n=15) and oral cancer patients (n=126).
Abstract No: 11.26
Oxidatant and Antioxidant Defence Mechanism in Chronic Myeloid Leukemia
Rizwan Ahmad, Anil K Tripathi, Payal Tripathi, Vinod Kumar Singh and Raj K Singh
Departments of 1Biochemistry and 2 Hemato-Oncology Unit, Department of Medicine, C.S.M. Medical
University, Lucknow, India
Background: Chronic myeloid leukemia (CML) is a myeloproliferative disorder with a
289
Indian Journal of Clinical Biochemistry Supplement, 2009/24
characteristic genetic rearrangement, the
Philadelphia chromosome. Oxidative stress, a
pervasive condition of increased amount of free
radicals is now recognized to be prominent feature
of various diseases including leukemias and their
progression. The relationship between the levels
of well known oxidative stress markers and
antioxidants status reflect better health indices and
postures. The present study was planned to review
the role of oxidative stress and antioxidant defense
system in patho-biology of CML. Oxidative stress
was assessed in terms of malondialdehyde
(MDA), total lipid hydroperoxide (LOOH) and
protein carbonyl (PC) content whereas antioxidant
status was evaluated in term of reduced
glutathione (GSH) and total thiol (T-SH) and total
antioxidant status (TAS) levels in plasma of CML
patients. Melatonin (MEL) level was measured
in urine.
Methods: The present study included 82 (male:
female; 1.8:1) CML patients and 70 (male: female;
1.5:1) age-sex matched healthy volunteers. Out
of 82 CML patients, 66 were in chronic phase
(CML-CP) and 16 in accelerated phase (CMLAP). The median age of CML patients was 35
years and that of healthy participants 34 years.
Oxidative stress and antioxidant defense system
markers in plasma were evaluated by
spectrophotometric procedures whereas MEL
level was determined in terms of 6sulphatoxymelatonine excreted in urine by ELISA
kit (IBL-Hamburg).
Results: There was a significant increase (p<0.05)
in plasma MDA, LOOH and PC levels in CML
patients as compared to healthy subjects. Our
results also showed that plasma MDA, LOOH and
PC levels were markedly elevated (p<0.05) in both
290
CML-CP and CML-AP as compared to healthy
volunteers. Antioxidant defense system which was
measured in term of reduced GSH, T-SH, TAS and
MEL was found to be significantly decreased
(p<0.05) in CML patients and its phases (CMLCP, CML-AP) as compared to healthy participants.
During the follow-up of total 66 CML-CP patients
for 12 months, 15 patients of CML-CP progressed
to the accelerated phase whereas 51 patients
remain in CML-CP phase. The mean plasma levels
of MDA, LOOH and PC in patients with CMLCP who progressed to CML-AP were found to be
higher than in patients with CML-CP who did not
progress to the accelerated phase. An elevation in
the plasma levels of MDA, LOOH, and PC was
observed in CML-CP patients who progressed to
CML-AP. The antioxidant defense system in
patients with CML-CP who advanced to CML-AP
was found to be decreased than in patients with
CML-CP who did not progress to the accelerated
phase. The antioxidant defense profiles remained
decreased in those CML-CP patients who
progressed to CML-AP.
Conclusion: It could be implicated that plasma
MDA, LOOH and PC levels may reveal the
magnitude of oxidative stress in CML patients
whereas reduced GSH, T-SH, TAS and MEL
explain the antioxidant defense system against
oxidative stress. All these parameters for oxidative
stress and antioxidant defense mechanism may
precisely reflect the proliferative signal
transduction, disease phenotype and its subsequent
disease progression. Plasma MDA, LOOH and PC
may serve as indices for oxidative stress and
disease progression in patients with chronic
myeloid leukemia whereas antioxidant defense
system plays an important role in nullifying the
oxidative stress.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.1
Antioxidant Markers and Liver Function Parameters in Chronic Alcoholics: A
Comparative Study between Koraga Tribal Community, Civilized Alcoholics and
Healthy Controls
Naureen Anwar1, Prasiddha Tilak1, Mahesh S1 and Dr Mungli Prakash1
1
Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka-576104; E-mail for
correspondence: [email protected]
Objective: It is well established that long-term
alcohol consumption leads to liver cirrhosis.
Sufficient work has been done on biochemical
markers of liver damage and antioxidant status of
civilized chronic alcoholics. In the current study
chronic alcoholics from a tribal community called
Koraga are analysed for the same parameters in a
view to assess the extent of liver damage as
compared to healthy controls and civilized
alcoholics.
Methods: Serum and urine samples from Koraga
alcoholics (n=28), civilized alcoholics (n=30) and
healthy controls (n=31) are analysed for liver
function parameters and antioxidant markers.
Liver function parameters are determined by
automated analyzer. Markers of antioxidant status
are estimated spectrophotometrically. The data are
analysed using SPSS (14.0)
urine GST in both civilized and Koraga alcoholics
(p<0.01). Serum thiol levels decreased in Koraga
subjects significantly (p<0.01) whereas the
decrease was not significant in civilized subjects.
There was significant increase in urine thiols of
civilized alcoholics (p<0.05) compared to controls,
however, such finding was not observed in Koraga
subjects. On Pearson correlation, serum GST
correlated positively with AST, ALT, total bilirubin
and urine GST (p<0.01), serum thiol levels
correlated negatively with AST and ALT (p<0.05).
Conclusion: Results of our study possibly indicate
that the extent of alcohol induced liver damage in
Koraga subjects is comparatively lower than
civilized alcoholics, even though the alcohol
consumption is found to be higher in them. There
may be some mechanism that is rendering them
resistant to alcoholic liver damage which needs to
be explored through further studies at molecular
Results: Compared to healthy controls there was level.
significant increase in AST, ALT, serum GST and
Abstract No: 12.2
Oxidative Stress in Organophosphorous Toxicity
*Dr.M.Jaiprakash Babu
Professor & Head of Biochemistry, Rajiv Gandhi Institute of Medical Sciences, Srikakulam, A.P
Objective: India is agriculture based country,
there is more use of organophosphates leading
to various abnormalities, which are largely
caused due to the oxidative stress. The aim
of the study is to assess oxidative stress and
antioxidant status in organophosphorous toxicity
in both acute and chronic exposure cases.
Methods: The study group consists of 40
farmers who have been involved mainly in
spaying activities in the paddy fields for more
than five years from near by villages as chronic
exposure cases and 20 cases of
oganophosphorous poisoning cases as acute
exposure cases. The control group consists of
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
30 volunteers from the same place with same
sex and age and did not exposed to
organophosphates.. Blood samples were
collected and analyzed for Malondialdehyde
(MDA), Superoxide dismutase (SOD) and vitamin
C. The observed values were compared with
control group. Statistical analysis was performed
by analyzing the data using student “t” test and
ANOVA.
Results: In the present study MDA levels were
significantly elevated in Acute Cases (p < 0.001)
and in chronic cases (p <0.001) due to the
inhibition of Acetyl choline esterase and
production of oxidative free radicals. Superoxide
dismutase (SOD) is the first line of defense
against reactive oxygen species. SOD levels
were increased in acute cases (p < 0.001) and
also in chronic cases (p <0.001) due to elevated
antioxidant status.
Conclusion: Vitamin C significantly decreased
in chronic cases than acute cases indicated the
low antioxidant status.
Abstract No: 12.3
Effect of Lemon Grass Oil Mouthwash on Patients with Gingivitis
Meghana Bhandarkar*, Mahima .B.S*, Madhur Agrawal*, Sonal Sukreet* , Dr.
Shobha.U.Kamath* and Dr.Meena AnandÏ%
* - Department of Biochemistry, Kasturba medical college, Manipal, Ï% - Department of Periodontics,
MCODS, Manipal.
Objective: The study was undertaken to determine
the influence of lemon-grass oil mouthwash on
patients with oxidative stress due to gingivitis, by
estimation of antioxidant levels in GCF (Gingival
Crevicular Fluid) and saliva.
Methods: In this study, 40 individuals were
divided into 2 groups :
A.Clinically healthy people as controls (10)
B.Patients with gingivitis (30)
The level of total thiols was determined by DTNB
and level of superoxide dismutase (SOD) by
Winter bourn et.al, both before and after the use
of the mouthwash.
Results: The level of SOD and total thiols were
found to have increased significantly in patients
with gingivitis in comparison with healthy
controls.
Conclusion: The lemon-grass oil in the
mouthwash is found to be effective in decreasing
the oxidative stress. The values of thiols and SOD
indicate this and support the conclusion.
Abstract No: 12.4
Oxidative Stress and Vitamin Antioxidant Status in Rheumatoid Arthritis.
Dr P.B Desai, Dr. Manjunath.S, Dr. Shivraj gowda, Dr. Sumangala Kadi, Dr. Shivprasad and
Dr. Chetana.K.
Department of Biochemistry, J N Medical college, Belgaum, Karnataka. Email: [email protected]
Background: Rheumatoid arthritis(RA) is a
chronic multi system disease of unknown cause.
292
A number of factors are implicated in the etiology
but none are decisively conclusive as causative
Indian Journal of Clinical Biochemistry Supplement, 2009/24
agents. However a major feature seems to be method modified by Karmarkar and Rajgopal, Vit
synovial inflammation hypothesized to be E by Quafie et al modified by Baker and Frank
mediated by self perpetuated reactive oxygen and VitC by Evelyn and Malloy method.
species(ROS).
Results :It was observed that MDA levels were
Objective: The present study was done ,to significantly elevated(p<o.oo1) along with
evaluate the oxidative stress by estimating diminished levels of antioxidant vitamins ie VitA,
malondialdehyde (MDA)levels and vitamin VitE and VitC in all patients of RA as compared to
antioxidant status by estimating Vitamin A(Vit A), healthy individuals.
Vitamin E(VitE) and VitaminC(VitC) in blood.
Conclusion: It can be concluded that free radicals
Methods: The present study included 40 clinically may be responsible for causing inflammation and
diagnosed rheumatoid arthritis patients and 40 age damage to joints. Depletion of vitamins give a
and sex matched healthy individuals .10 ml of clue that their substitution in food may have some
blood was drawn and MDA was estimated by therapeutic use in RA.
Thiobarbituric acid method, Vit A by Basses et al
Abstract No: 12.5
Changes in Advanced Oxidation Protein Product (AOPP) in Moderate and
Severly Uremic Rats
Merin Iype C*, Subramanya Upadhya**, Sharmila Upadhya** and Gopalakrishna Bhat***
*Department of Physiology, SNIMS, Chalakka, **Department of Physiology and Biochemistry, SGU,
Grenada, West Indies, ***Department of Biochemistry, KMC, Manipal. Email: [email protected]
Background: Oxidation of proteins leads to the
formation of carbonyl compounds. Carbonyl
formation may be an early marker for protein
oxidation. Products formed by oxidation of
proteins are called advanced oxidation protein
products (AOPP), which increase in patients with
renal failure.
Normal group. After the development of uremia,
blood samples were collected at 4, 8, 12 & 16
weeks for estimation of protein carbonyls by
DNPH method.
Results: There was a significant elevation in
Protein carbonyls in both the uremic groups when
compared to sham and normal controls at all weeks.
Objective: To estimate the plasma levels of
In addition the level of protein carbonyl showed a
protein carbonyl, an uremic toxins at various
significant difference between moderate and severe
weeks of chronic renal failure in rats and establish
uremic groups in 4, 12 and 16 week groups.
their relationship with the severity and metabolism
Conclusion: Protein carbonyl is a uremic toxin
during renal failure.
which increases during renal failure. There is a
Methods: Two models of stable uremia was
developed A. Moderate uremia B. Severe uremia. progressive increase in the level of protein carbonyl
Both these models were compared with two depending on the severity of the condition which
groups of controls A. Sham operated group B. is seen for the first time in nephrectimized rats.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.6
Oxidative Stress and Calcium Levels in Senile and Diabetic Catract Patients
Deepa K, * Sumana Kamath, Vivian D’Souza and Nandini M
Dept of Biochemistry,* Dept of Ophthalmology Kasturba Medical College, Mangalore , 575001;
Email: [email protected]
Background: One of the often seen consequences
of aging process is the development of senile
cataract. Disturbance in balance between the
oxidant and antioxidant levels is thought to be one
of the risk factor for the process of
cataractogenesis. The transparency of lens which
depends on the protein structure and optimum
concentration of intracellular calcium is altered
by the process of oxidative stress.
Results: Significant increase in the serum MDA
was observed in patients with diabetic cataract.
Antioxidant activity was significantly reduced in
the serum as well as the lens in these subjects.
However there was no significant change in the
serum and lens calcium levels. Comparison
between mature and immature cataractous lenses
showed a significant increase in the calcium and
decrease in antioxidant activity. A positive
association of lens calcium with serum MDA was
Objective: The main objective of the present study
observed.
was to compare the degree of oxidative stress and
calcium level in senile and diabetic cataract Conclusion: Degree of oxidative stress is more in
subject.
diabetic subjects indicating that they are prone to
oxidative stress at much earlier age. Increase in
Methods: Study included 25 senile cataract
calcium content of mature lenses suggests its role
patients of either sex and 25 diabetic cataract
in the process of cataractogenesis.
patients. Blood samples were collected during preSupplementation of adequate dose of antioxidants
operative period. Serum was analyzed for MDA,
may be beneficial in delaying this and avoiding
total antioxidant activity and total calcium while lens
the complications.
was analyzed for antioxidant activity, and calcium.
Abstract No: 12.7
Oxidative Stress in Erythrocytes and Plasma of Healthy Controls
Nirjala Laxmi Madhikarmi and Kora Rudraiah Siddalinga Murthy
Department of Biochemistry, Central College Campus, Bangalore University, Bangalore- 560 001 India
Email- [email protected], [email protected]
Objective: Oxidative stress is a biochemical
disequilibrium produced by the excessive
production of free radicals and reactive oxygen
species, which provoke oxidative damage to
biomolecules. Malondialdehyde is the major and
one of the most frequently used indicators of lipid
peroxidation product that is mutagenic and
tumorigenic. The present study was carried out to
determine the oxidative stress in erythrocyte and
plasma of healthy human subjects.
294
Methods: Blood was collected from thirty (30)
healthy individuals (15male and 15 female), age
ranging from 23 to 53 years. Lipid peroxidation
was analysed by the estimation of
malondialdehyde concentration both in erythrocyte
and plasma. Malon-dialdehyde concentration was
determined by estimating thiobarbituric acid
reactive substances (TBARS) by the method of
Buege and Aust.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Results: The mean ages of male and female
healthy controls were 30.93 ± 7.85 years and 26.70
± 6.98 years respectively. TBARS in plasma and
erythrocyte showed highly significant correlation
with respect to body mass index (BMI). In female,
lipid peroxidation was higher in plasma but lower
in erythrocytes. On the other hand, in male lipid
peroxidation was higher in erythrocytes than
compared to plasma.
Conclusion: Our findings suggest that BMI is one
of the governing for the increase of oxidative stress.
The potential relationship between TBARS in plasma
and erythrocytes was observed in control subjects.
Abstract No: 12.8
Oxidant and Antioxidant status in Metabolic Syndrome
PVLN Srinivasa Rao*, N. Manasa Kumari*, Alok Sachan**, KVN Raju, M.M.Suchitra*, V.
Seshadri Reddy* and Aparna R. Bitla*
*Department of Biochemistry, **Department of Endocrinology, Sri Venkateswara Institute of Medical
Sciences, Tirupati, A.P. .Email: [email protected]
Objective: Oxidative stress is involved in the
pathophysiology of diabetes and cardio vascular
complications of metabolic syndrome.
Endothelial dysfunction which is the key feature
of metabolic syndrome and its vascular
complication is intimately linked to insulin
resistance. This relationship is partly due to
oxidative stress. The present study was taken up
to evaluate the oxidant and antioxidant status in
patients with metabolic syndrome as compared
with healthy controls.
Methods: Twenty five patients with metabolic
syndrome diagnosed on the basis of WHO criteria
taken as subjects along with twenty five, age and
sex
matched
healthy
individuals.
Malondialdehyde (MDA), as an index of changes
in lipid peroxidation was estimated as
Thiobarbituric acid reactive substances (TBARS),
Plasma total antioxidant capacity as Ferric
reducing ability of plasma (FRAP), Superoxide
dismutase activity (SOD) by continuous
Spectrophotometric rate determination.
Results: A significant increase (p<0.001) in MDA
levels in study group was observed when compared
to the control group, where as FRAP levels were
decreased in study group compared with control
group (p<0.001). SOD activity was decreased but
not statistically significant in study group when
compared with control group.
Conclusion: The findings of the present study
suggest the presence of oxidative stress in patients
with metabolic syndrome which further increase
the cardiovascular risk in these patients. Hence
management should be aimed at treating the
atherogenic factors associated with metabolic
syndrome like dyslipidemia, hypertension etc., and
also correcting the antioxidant status.
Abstract No: 12.9
Study of Antioxidant Enzymes of Seminal Plasma in Association with
Mental Stress Subjects
R.K Padalkar, V.R Pandhare, P.S Kamble and P.D Zende
PD VVPF’s Medical College, Ahmednagar, Maharashtra, India, Email:[email protected]
Objective: Mental stress, which is responsible for and social problems. It is reported that mental stress
various disorders including abnormality in sperm causes abnormality in sperm quality. In the present
cell functions, is one of the most important medical study we investigated the impact of mental stress
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
in MBBS students due to final examination and
after examination on free radical activity and three
important antioxidant enzymes of seminal plasma,
Superoxide Dismutase (SOD), Glutathione
Peroxidase (GSH) and Catalase.
Methods: For carrying out morphological and
biochemical analysis, semen samples were
collected twice from 50 healthy male volunteers,
who were third semester students of a medical
college, just before and after stress period 12.00 ±
0.50 week final examination and 12.00 ± 0.50
week gap after final examination, venous blood
samples were also withdrawn and serum separated
for assessment of cortisol levels. Psychological
stress of participants was assessed on the basis of
questionnaire and elevated serum cortisol level.
Similarly non stress subjects were evidenced by
the study of questionnaire and normal serum
cortisol level.
Results: The results demonstrated spermatozoa
concentrations, motility index and percentage of
rapid progressive motility decreased under stress.
Moreover, serum cortisol and seminal plasma
Lipid Peroxide (LPO) levels were found elevated
along with decreased seminal plasma GSH and
reduced SOD.
Conclusion: From present study our results
indicated that mental stress negatively affected
semen quality and antioxidants level is positively
correlated with semen characteristics and the
concentration of antioxidant scavengers.
Abstract No: 12.10
Role of Mucuna Pruriens on Antioxidant Enzymes of Seminal Plasma in Association
of Mental Stress Subjects
VR Pandhare, RK Padalkar, PS Kamble and PD Zende
PDVVPF’s Medical College, Ahmednagar, Maharashtra, India Email: [email protected]
Objective: In the present study we investigated with M. prurines seed powder (5g day-1) orally and
the role of Mucuna Pruriens on activityof rest 25 individuals were kept free from dose.
antioxidant enzymes of seminal plasma in the
Results: The results demonstrated spermatozoa
mental stress subjects.
concentrations, motility index and percentage of
Methods: Semen samples were collected thrice rapid progressive motility decreased under stress.
from 50 healthy male volunteers, who were third Moreover, serum cortisol and seminal plasma
semester students of a medical college, just before Lipid Peroxide (LPO) levels were found elevated
and after stress period 12.00 ± 0.50 week final along with decreased seminal plasma GSH and
examination and 12.00 ± 0.50 week gap after final reduced SOD. M. Pruriens significantly
examination, venous blood samples were also ameliorated psychological stress and seminal
withdrawn and serum separated for assessment of plasma LPO level along with improved
spermatozoa concentration motility index and
cortisol level. SOD and Catalase activities were
rapid progressive motility. Treatment also restored
measured in the seminal plasma. Psychological
the levels of SOD, Catalase and GSH in seminal
stress of participants was assessed on the basis of
plasma of stress subjects.
questionnaire and elevated serum cortisol level and
vice versa. Stress observed in the individuals after Conclusion: From our results it is concluded that
the period of 12.00 ± 0.50 week gap after final M. Pruriens not only reactivates the antioxidant
examination was arranged into two groups, 25 defense system of infertile male but also helps in
each. The first 25 individuals were administered the management of stress and improves semen quality.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.11
Relationship between ROS and Antioxidants in Male Infertility
Parineeta Samant*, Prof P G Samant** and Dr Z G Badade***
*Lecturer, **Professor, ***Professor & Head, Department of Biochemistry, MGM Medical College,
Kamothe, Navi – Mumbai, Pin-410 209; [email protected] or
[email protected]
Objective: There is growing evidence that
damage to spermatozoa by reactive oxygen
species (ROS) has a key role in male infertility.
The aim of the present study was to assess seminal
plasma Malondialdehyde (MDA), Vitamin C
concentration and Catalase activity. These oxidant
& antioxidants represents the lipid peroxidation
and spermicidal antioxidant activity respectively.
We aimed to correlate the relationship of seminal
parameters, MDA concentration with Catalase
activity and Vitamin C levels in control and study
group.
Methods: Specimens were divided into two
groups: Group I- Normospermia (n=30); Group
II-Oligoasthenozoospermia (n=30). Seminal
MDA concentration was measured by K Satoh’s
method. Seminal Catalase activity was measured
by A K Sinha’s assay. Vitamin C levels are
measured by 2,4-DNPH method.
Results: Seminal parameters, MDA, Vitamin C
levels and Catalase activitiy in both groups were
compared. MDA concentrations in
oligoasthenozoospermic group were significantly
elevated.
Catalase
activities
in
oligoasthenozoospermic groups were significantly
decreased. Vitamin C levels were significantly
lower in oligoasthenozoospermic patients,
comparing to the levels found in normospermic
men. Assessment of ROS, Catalase and Vitamin
C may assist in diagnosis and prognosis of male
infertility.
Conclusion: Treatment strategies must be directed
toward lowering of ROS levels to keep only a small
amount necessary to maintain normal cell function
and improve antioxidant status.
Abstract No: 12.12
Study of Lipid-Peroxidation and Antioxidant Status in Malaria Patients
Pawan Kare*, B.K.Agrawal* and V.K.Sharma**
*Dept. of Biochemistry, **Dept. of Medicine. Gandhi Medical College, Bhopal.
Email: [email protected]
Objective: Malaria is a major health problem in
developing countries accounting for 2-3 million
deaths per year. Oxidative stress (Lipidperoxidation) plays an important role in
development of malarial anemia. The present
study was done to assess MDA as a marker of
lipid-peroxidation and SOD as an antioxidant in
malaria patients.
Methods: The present study included 50 untreated
malaria cases compared to 25 age and sex matched
healthy control cases. In these patients following
investigation were carried out:1. MDA level was estimated by Buege.et. al.(1978)
method.
2. SOD activity was estimated by Das.et. al.(2000)
method.
3. Hb was estimated by cyan methemoglobin
method.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Results: The MDA level was significantly
increased while SOD level and Hb were
significantly decreased in both groups of malaria
patients as compared to control groups. The MDA
level was found to be significantly (P<0.001)
increased while SOD level and Hb were found to
be significantly (P<0.001) decreased in P.Vivax
as compared to control group. The MDA level was
found to be significantly (P<0.001) increased
while SOD level and Hb were found to be
significantly(P<0.001) decreased in P.Falciparum
as compared to control group. The MDA level was
found to be significantly (P<0.05) more increased
in P.Falciparum as compared to P.Vivax while SOD
level was found to be significantly (P<0.001) more
decreased in P.Vivax as compared to P.Falciparum.
The Hb level was found to be significantly(P<0.01)
more decreased in P.Falciparum as compared to
P.Vivax.
Conclusion: We concluded that lipid-peroxidation
is a significant problem in malaria patients. A high
level of MDA and decline level of SOD activity
and Hb level are associated with malarial anemia
Abstract No: 12.13
A Study of Oxidative Stress in Cancer Patient Before and After Supplementation of
Vitamin C and E
Dr. Pranami Bordoloi ,Dr. Bikash Kr. Chaudhury, Dr. Chandan Kr. Nath, and *Dr. Dipali Das
Department of Biochemistry,Gauhati Medical College and Hospital , Guwahati – 781032 Assam,
Senior Resident Doctor, Department of Biochemistry, NEIGRIHMS, Shillong, Meghalya; Email: drpranamibordoloi @ gmail.com
Objective: Cancer is the second leading cause of
death behind heart disease. Increased lipid
peroxidation is due to the altered ratio between
free radicals and antioxidant status. The study was
carried out to analyze and evaluate the relationship
between antioxidant vitamin C & E
supplementation and its effect on the lipid
peroxidation in the cancer and normal population.
Methods: We estimated Malon-dialdehyde, lipid
peroxidation marker colorimetrically by
Thiobarbituric acids Reactive Substances
(TBARS) and uric acid is by Uricase method.
Results: Statistical analysis is done by Student‘t’
test. MDA values in both the study groups
decreased significantly after 7 days of vitamin
supplementation (p< 0.001). Uric acid values in
both the studied group increased significantly after
Vitamin Supplementation for 7 days (p< 0.001).
Conclusion: The study suggested that MDA value
reduced in cancer patients within one week of
antioxidant vitamin supplementation but for
reduction of uric acid levels longer period of
vitamin supplementation is required in both the
population.
Abstract No: 12.14
Biochemical Antioxidative Parameters in Type 2 Diabetic Patients with
Cardiovascular Complications.
Prashant Nigam*,B. K. Agrawal*, V. K. Sharma** and Bhawna Bhimte*
*Dept. of Biochemistry. ** Dept. of Medicine, Gandhi Medical College, Bhopal.
E-mail – [email protected]
Objective: Prolonged hyperglycemia is the major
factor in the pathogenesis of atherosclerosis in
298
diabetes, which can lead to cardiovascular
complications the generation of reactive oxygen
Indian Journal of Clinical Biochemistry Supplement, 2009/24
species (oxidative stress) may play an important P<0.001),(Vit C P<0.01) decreased as compared
role in the aetiology of diabetic complications.
to control. In TYPE 2 DM with Hypertension
Methods: The present study included 50 Type2 group almost similar observation were found to
DM with AMI, 50 Type2 DM with Hypertension TYPE 2 DM with AMI group. Value of MDA was
patients with 50 normal control group. In these found to be statistically higher significant
groups following investigations were done to (P<0.001) increased while SOD, and TAC was
assay antioxidant activity. 1. The activity of statistically significant (P<0.001) decreased. The
antioxidant enzyme Superoxide dismutase in value of Vit C was found statically less significant
erythrocytes by Das et al method 2000, 2. The (P<0.01) decreased. But statistically insignificant
plasma level of Vit C by Omaye et al method 1979, (P>0.05) difference was observed when TYPE 2
3. The lipid peroxidation through measuring DM with AMI group compared to TYPE 2 DM
Malondialdehyde level in erythrocytes by Buege with Hypertension group.
et al method 1978, 4. The Total Antioxidant Conclusion: It can be concluded that the high
MDA and low SOD, Vit.C and TAC levels are
capacity by D. Koracevic et al method 2001.
Results: In TYPE 2 DM with AMI group value associated with T2DM with AMI and T2DM with
of MDA was found to be statistically highly Hypertension hence antioxidants, may be
significant (P<0.001) increased while value of administered along with Type2 Diabetic and
SOD, Vit C and TAC was significantly (TAC, SOD cardiac therapy.
Abstract No: 12.15
Evaluation of Flow Rate, pH, Buffering Capacity, Calcium, Total Protein and Total
Antioxidant Levels of Saliva in Caries Free and Caries-active Children – an in vivo Study
*Dr. Preethi.B.P, **Dr. Jayaprakash Murthy.D.S and ***Dr. Reshma Dodawad
*Assistant Professor; **Professor, Dept of Biochemistry, J.J.M.Medical College, Davangere,
Karnataka;
***Asst Prof, Dept of Pedodontics, S.D.M.,Dharwad Karnataka.
[email protected]
Objective: The purpose of this study was to
evaluate the relationship between the
physicochemical properties of saliva such as flow
rate, pH, buffering capacity, calcium level, total
protein and total antioxidant levels in caries free
and caries active children.
capacity, total protein, calcium and total
antioxidant capacity. The data was then statistically
analyzed using students ‘t ‘test {unpaired}.
Results: The results revealed that when all these
parameters were compared among the caries free
and caries active children, the flow rate, pH and
Methods: The present study included one hundred buffering capacity were slightly reduced in caries
and twenty healthy children who were divided into active children, but the total protein and total
two groups; Group- I and Group- II comprising antioxidant capacity of saliva increased
of age groups 7 to 10 and 11 to 14 years significantly in caries active children and the total
respectively. Both the groups were then sub- calcium decreased significantly in caries active
divided equally according to gender. They were children.
further divided into caries free and caries active
children with 15 children in each group. Conclusion: Within the limitation of this study,
Unstimulated saliva was collected by suction we can conclude that, the physicochemical
method and flow rates were determined. The properties of saliva play a major role in the
samples were then analyzed for pH, buffering development of caries
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.16
Comparative Study of Free Radical Activity of Plasmodium Falciparum and
Plasmodium Vivax Malaria Patients
PS Kamble, RK Padalkar, SR Kharade, PD Zende and VR Pandhare
PDVVPF’s Medical College, Ahmednagar, Maharashtra, India;
Email: [email protected]
Objective: The present study was undertaken to
study the free radical activity in the malaria
patients suffering from Plasmodium Falciparum
(n=14) and Plasmodium Vivax (n=21) against the
control subjects.
Plasmodium Vivax infected patients and healthy
controls. Serum Ceruloplasmin / Lipid
Peroxidation ratio are found to be significantly
lower in the malaria patients (p<0.001) when
compared with controls. While correlation between
them (r=0.521) was direct positive in Plasmodium
Methods: Lipid Peroxidation was assessed by Falciparum malaria as compared to Plasmodium
measuring serum lipid peroxide in both groups of Vivax and healthy controls.
malaria patients by using Malondialdehyde as
standard. The serum Ceruloplasmin is also studied Conclusion: The parallel changes were due to
along with serum Lipid Peroxidation.
different mechanism. Increase in serum Lipid
Peroxidation was due to overactivity of free
Results: The level of serum Lipid Peroxidation radical, which corresponds with severely tissue
were significantly high (p<0.001) in patients with damage while increase in serum Ceruloplasmin
Plasmodium Falciparum malaria as compared to was due to acute phase response in malaria.
Abstract No: 12.17
Alterations in Oxidant and Antioxidant Status in Early Alcoholic Liver Disease
Ms. Sripradha. R, Dr. M.G. Sridhar and P.Doureradjou-JIPMER
Objective: Oxidative stress plays a crucial role in
the pathogenesis of Alcoholic liver disease.(ALD).
The present study was undertaken to evaluate,
compare and correlate the oxidative stress
parameters with the enzymatic changes in the
serum of ALD patients and healthy controls.
commercial kits adapted to auto analyzer
respectively.
Results: ALD patients showed significantly higher
values of MDA, PC, TSA, GGT, AST and
significantly lower GSH level. There was
increased ALT, decreased PSA and the values were
Methods: The study included thirty ALD patients not statistically significant. Significant correlation
and equal number of matched controls. was observed among MDA, PC, TSA, GSH, GGT
Malondialdehyde (MDA) was estimated by and AST.
Thiobarbituric acid method, Protein carbonyls
(PC) by modified Levine’s method, Total and Conclusion: The study revealed that oxidative
Protein bound sialic acid(TSA, PSA) levels by stress is strongly associated with changes in both
modified Aminoff ’s method, reduced sialic acid and enzymes in ALD. Further studies
glutathione(GSH) by Dithiobis-2nitrobenzoic acid are required to explore the relevance of these
method and enzymes (GGT,AST and ALT) by markers for prognostic purposes.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.18
Respiratory Burst Enzymes of Leukocytes in Withaferin Treated Carcinoma of
Uterine Cervix
Reshma K, AV Rao, Dinesh M and Vasudevan D.M
Department of Biochemistry, KMC, Mangalore
Objective: Withaferin,an active component
obtained from the dried root extracts of withania
somnifera (ashwagandha), showed antitumor and
radiosensitising effects in animals. A similar
approach in human cancer patients could probably
increase the therapeutic outcome. Respiratory
burst enzymes of the leukocytes are involved in a
delicate interplay of generating and scavenging
free radicals. Radiotherapy (RT), could influence
the activity of these enzymes by generating free
radicals. Furthermore, radiosensitisers also
sensitise the tumor tissues to RT by similar
mechanisms.
cervix , which would perhaps aid in the
understanding
of
radiosensitising
mechanisms.Blood samples were collected from
stage IIIB carcinoma of uterine cervix patients
(n=20), before starting treatment,after 15 days and
after 30 days of treatment with RT and withaferin.
Age and sex matched controls (n=25)were also
considered for comparison.
Results: A significant decrease in NADPH oxidase
was observed in baseline samples of cancer
patients when compared to controls.Except for this
,there was no change in the activities of other
enzymes, when cancer patients were compared to
Methods: Therefore a study of the respiratory controls or when baseline values were compared
burst enzymes namely NADPH oxidase with that of follow up in case of patients.
Myeloperoxidase (MPO), Glutathione
(GSH),Glutathione peroxidase (GSH-PX), Conclusion: Based on the results of this study, it
Glucose 6 phosphate dehydrogenase (G6PD) and appears that the mechanism of action of withaferin
Superoxide dismutase (SOD) were undertaken in is yet to be explored
leukocytes of patients with carcinoma of uterine
Abstract No: 12.19
Advanced Oxidative Products of Proteins and Total Antioxidants in Gastric
Carcinoma Patients
Anita, Sudha K, Beena V Shetty and Gayatri M Rao
Dept. of Biochemistry, KMC, Mangalore
Objective: It has been suggested that oxidative
stress, defined as a shift in pro-oxidant/oxidant
balance towards oxidants has been associated with
the pathogenesis of many diseases including
carcinogenesis. Reactive oxygen species can
induce carcinogenesis via injury to
macromolecules such as DNA, carbohydrates
and proteins.
Methods: 25 primary gastric carcinoma patients
and 30 healthy control were included in the study.
Advanced oxidation protein products, total protein,
albumin and total antioxidant activity in plasma
were estimated.
Results: Our studies demonstrated a significant
increase in AOPP, A:G ratio(p=0.003,) and total
antioxidant activity(p=0.014).
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Conclusion: The findings suggest that gastric
carcinoma is associated with oxygen derived free
radicals accumulation and depletion of total
antioxidant activity has lead to oxidative stress and
advancement of oxidative-antioxidative disorders
followed by progression of gastric cancer.
Abstract No: 12.20
Protein Oxidation and Antioxidants in Oral Cancer
Sudha K, Vinodchandran, Gayathri M Rao and Beena Shetty
K.M.C., Mangalore
Objective: The complex series of cellular and
molecular changes that occur through the
development of cancer can be mediated by a
diversity of endogenous and environmental
stimuli.Free radicals have long been known to be
mutagenic.
albumin.Data compared with that of age and sex
matched controls.
Results: The results indicate that there is a
significant increase in protein oxidation and a
significant decrease in total thiols in oral cancer
patients compared to normal subjects.Plasma GSH
Methods: This study examines the role of free and albumin also showed a significant decrease
radical induced protein oxidation and antioxidant in these patients compared to healthy controls.
defence in oral cancer patients.Plasma advanced Conclusion: We conclude that protein oxidation
oxidation protein products (AOPP) was estimated and decreased antioxidants can be considered to
as protein oxidation marker.Antioxidant status was be important players in multi mechanistic
evaluated by determining GSH,thiols and pathogenesis of oral cancer.
Abstract No: 12.21
Oxidative Stress in Maternal and Cord Blood of Pre Term Infants
Revathi.R, Saravanan.A, Ramakrishnan.T, Bharathy.N and Sujitha.S
Department of Biochemistry, SRM Medical College and Research Centre – Chennai
Background: Oxygen is an essential component
of living organism but formation of ros (reactive
oxygen species) seems to be common place in
aerobically metabolizing cells. In healthy human
body, ros and anti-oxidans remain in balance but
when balance gets disrupted, ros increases and
leads to occurance of oxidative stress. This
oxidative stress has been implicated in enormous
variety of physiological and pathological
disorders.
Objective: The main objective of the present study
is to estimate malondialdehyde (MDApreoxidant), anti oxidant enzymes SOD
(superoxide dismutase) & CAT (catalase) in
maternal and cord blood of preterm infants
compared to that of normal individuals.
302
Methods: The study group of 25 mother -infant
pairs at term delivery (test groups) was selected
for the study. Serum samples were analyzed for
MDA, SOD and catalase. Student ‘t’ test was used
for statistical analysis.
Results: There was a significant increase in
lipidperoxidase MDA level in preterm motherinfant pairs compared to term (p>0.001), The
reduced levels of SOD and CAT observed in
preterm mother -infant pair compared to term
mother- infant pair.
Conclusion: The result of present study indicates
that there is a increased oxidative stress in preterm
infant -mother pair compared to term motherinfant pair.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.22
Effect of Renoprotective Therapy on Plasma Thiols and Ferric Reducing Antioxidant
Power in Children with Nephrotic Syndrome
Rimshida Malik, Priya Pai, Dr. Krishnananda Prabhu, Dr. Nalini Bhaskaranand, and Dr. Anjali Rao
Department of Biochemistry , Kasturba Medical College Manipal, India-576104.
E mail: [email protected] Ph: 09986353006
Background: Oxidative damage by free radicals
has been implicated in number of clinical disorders
including renal injury. Reactive oxygen species
promote cell injury by lipid peroxidation which
disrupts the structural integrity of the tubular
epithelial cells and increases glomerular
permeability to proteins along with alteration of
glomerular hemodynamics. In the present study,
biomarkers of oxidative stress like protein thiols
and ferric reducing/ antioxidant power were
estimated in children with nephrotic syndrome
before onset of renoprotective therapy and after 4
yrs of treatment.
and after a period of four years of
renoprotectivetherapy (enalpril, aspirin, and
dipyridamole) and their respective levels were
compared. Those patients who recived oral
prednisolone (40-60 mg/m2/day) for period of 4
weeks but did not go into remission phase were
included in the study.
Methods: Plasma protein thiols and ferric
reducing/antioxidant power were measured in
children suffering from nephrotic syndrome
attending Kasturba Medical College Hospital,
Manipal before the onset of renoprotective therapy
References:
Results: We observed a significant decrease in
both plasma protein thiols and ferric reducing/
antioxidant power (p < 0.001) after treatment as
compared to their initial values.
Conclusion: This may indicate that antioxidant
Objective: To evaluate the effectiveness of status of these children was decreased as there was
renoprotective therapy on the levels of these a decreased demand due to improvement in clinical
state
parameters.
1. Contrib Nephrol. 2008;160:17-28
2. Clin Chim Acta. 2002; 325: 147 -150
3. Am J Med. 1991; 91: 31S – 38S
4. Arch Dis Chil. 200; 82: 76 – 78
Abstract No.12.23
Role of Lipid Peroxidation and Enzymatic antioxidant Status in complicated Pregnancies:
Sadanand B Patil 1, M.V. Kodliwadmath 1 and Sheela M. Kodliwadmath 2
Asst. Professor Professor, Dept. of Biochemistry1 and professor, Dept of Obstetrics and gynaecology2;
J.N. Medical College, Nehrunagar, Belgaum-10, Karnataka.
Objective: Pre-eclampsia and eclampsia are
pregnancy complications with serious
consequences for mother and infant. Uncontrolled
lipid peroxidation may play an important role in
the pathophysiology of pre-eclampsia and
eclampsia by causing vascular endothelial cell
dysfunction. Antioxidants serve to control lipid
peroxidation. We tested that antioxidant protective
mechanisms are diminished in women with Preeclampsia and eclampsia.
Methods: Lipid peroxidation and antioxidant
markers were assayed in 25 healthy non-pregnant
women as control, 25 third trimester normal
pregnant, 25 pre-eclamptic and 25 eclamptic
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
patients of the same trimester by standard
spectrophotometer methods.
Results: In Pre-eclampsia and eclampsia
malondialdehyde, a product of lipid peroxidation
was significantly increased while enzymatic
antioxidants like superoxide dismutase,
Glutathione perxidase Glutathione reductase and
catalase were reduced significantly as compared
to normal pregnant and non-pregnant controls.
Conclusion: Lipid peroxidation is an important
factor in the pathogenesis of pre-eclampsia and
eclampsia. The decrease in antioxidants is
probably due to compensatory nature responding
to the increased lipid peroxide load in preeclamptic and eclamptic patients and may reflect
the severity of the disease. Early attention,
intensive management and better treatment with
antioxidant vitamins may be essential for
improving the maternal and foetal outcome in PIH
Abstract No: 12.24
Study of Antioxidant Status with Respect to AF after Cardiac Surgery
Shalini Nair*, Khalid Iqbal**, Madhavi S Phadke* and Jagdish Khandeparkar**
*Department Of Biochemistry, LTMG Hospital & LTM Medical College, Sion, Mumbai – 400022,
**Department of Cardiovascular & Thoracic Surgery, LTMG Hospital & LTM Medical College, Sion,
Mumbai - 400022
Objective: Atrial Fibrillation (AF) is the most
common sustained tachyarrhythmia in patients of
valvular heart disease. Post-operative AF
continues to be the most common complications
after open heart surgery. It is associated with
increased cardiovascular morbidity and mortality.
Our attempt was to study the role of oxidative
stress in patients after cardiopulmonary bypass.
collected preoperatively and on the 5th post
operative day for the measurement of various
antioxidant and oxidative stress markers
[glutathione, vitamin C, super oxide dismutase,
MDA].
Results: Decrease in the antioxidants and increase
in the free radical was evident in all the 3 groups.
Glutathione, Super oxide dismutase and Vitamin
Methods: Patients undergoing valve procedures C showed a decrease in their levels on the 5th
postoperative day as compared to the preoperative
were categorized in to 3 study groups namely,
value; p<0.001. MDA showed an increase on the
1. Patients who were in normal sinus rhythm
5th day which was more distinct in Gp3 (8.5±3.6
(NSR) pre and post operatively (A1).
vs. 11.07±3.46); p<0.001.
2. Patients who converted in to NSR
Conclusion: Patients who exhibit AF after cardiac
postoperatively from AF (A2).
surgery have significantly increased oxidative
3. Patients who were in AF preoperatively and
stress, and significantly lower antioxidant status
continued to be in AF postoperatively also (A3). which can result in increased myocardial
Post operative AF was assessed by 12 lead oxidation. It is also evident that this differential
electrocardiogram and required initiation of response is present at the systemic level and not
antiarrythmic therapy. Blood samples were just within the myocardium.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 12.25
Chronic Alcohol Induced Tissue Injury: Microarray Analyses of Gene Regulation
in the Disease Process
R. Sandeep, P.Nagababu, Sunitha T, Rekha, D, Farid, M., Malathi, R., .Ranjeetha, N, and R.
Polavarapu*
Dept. of Biochemistry, Katuri Medical College, Guntur, AP 522019, India, *Emory University School
of Medicine, Atlanta, GA 30322, USA
Objective: Chronic alcohol abuse is known to
have a positive correlation with the onset of tissue
injury including liver cirrhosis, pancreatitis,
gastitis, acute respiratory distress syndrome
(ARDS) and an increased risk for the development
of breast cancer. Though the causal relationship
between the alcohol abuse and the disease process
is not clear but was implicated metabolic
activation of ethanol in these tissues might be the
causative of the disease process. Here, using
alcoholic rat animal model and Affymetrix high
density gene chip technology, we report
differential gene regulation in different tissues due
to chronic alcoholism.
Methods: Male and Female Sprague-Dawley rats
were pair-fed with isocaloric Lieber-DeCarli
liquid diets for six weeks. Different tissues of
interest were isolated and subjected for microarray
analyses using Affymetrix gene chip technology.
Results: The data suggests like in liver, there is a
state of oxidative stress in those tissues with organ
injury and is correlated with phase I and II enzymes
that are involved in ethanol metabolism. There
was an increase in the expression of alcohol
dehydrogenase and several cytochrome p450 gene
families in Antrhrum and lung. Several genes
involved in glutathione homeostasis increased
expression levels, including glutathione Stransferases, several inflammatory proteins and
oxidative stress genes are down regulated at the
mRNA level. In the pancreas, it was suggested
that several oxidative stress genes and genes that
are involved in the genesis of inflammation were
differentially regulated.
Conclusion: This produces an imbalance in the
homeostasis of pro and anti-oxidative stress
producing, inflammation, reduced immunity and
organ damage at large
Abstract No: 12.26
Involvement of Cellular Oxidants in Deregulated Redox Homeostasis in Diabetes
Mellitus
P. P. Singh* and Farzana Mahdi**
* Professor Emeritus ** Director Academic’s, Department of Biochemistry, Era’s Lucknow Medical
College & Hospital, Sarfarazganj, Hardoi road, Lucknow. Email [email protected]
Background: The debate on reactive oxygen
species (ROS) involvement, as a mediator in the
genesis of diabetes mellitus (DM) (both in type 1
& 2) and as a critical indicator in development of
diabetic complications continues, especially in
Indian context which tops the global list of diabetic
patients. The moot issues about ROS participation
in DM are: a) heightened oxidative stress (OS) is
universal or selective. b) cause or consequence. c)
central or peripheral. d) facultative or obligatory.
e) mechanism/s for activated generation of ROS
pathways. f) antioxidants (AO) in the management
of the disease. g) why majority of clinical trials
have failed to achieve envisaged benefits. The
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
studies of our group have revolved around these
issues.
glucose induced hyperglycemic spikes are
accompanied with raised OS. 5) most importantly
Methods: Case controlled studies and clinical experimental induction of chronic or acute OS in
trials among several controls and experimental animal models is not accompanied with
hyperglycemia distinctively suggesting that OS
studies on animal models.
alone is not a causative factor. 7) AO treatment
Results: Our results do not posit a putative has almost no value in management of patients
involvement of OS as measure risk factor in DM with good antioxidant status. As a corollary, several
or in associated complication nor benefits of AO pathways can get stimulated to raise ROS
treatment in non deficient subjects.
production in most of the patients. This may raise
Conclusion: We conclude from our data: 1) raised OS to a certain degree, but its contribution to
development of DM or further complications is
OS or weak AO network is present only in selected
only a minor one and only in small number of
patients. 2) in majority of patients it begins as
cases. AO can not prevent or cure DM with or
consequence 3) in humans it does not initiate
without complications nor can attenuate it if
insulin resistance but may aggravate it. 4) diet or
patients have pre existing AO status.
Abstract No: 13.1
Oxidative Stress and Inflammatory Response in Pre-eclampsia
Sathish B M 1, Bobby Z 1 and Habeebullah S 2
Department of 1Biochemistry and 2Obstetrics&Gynaecology, JIPMER, Puducherry
Objective: To compare markers of oxidative stress Results: MDA, PC, PBS, us-CRP levels were
and inflammatory response in pre-eclampsia significantly increased in pre-eclampsia group
versus normal pregnant women.
compared to the control group. Statistically
significant correlation was observed between
Methods:Reduced glutathione (GSH), MDA levels and the CRP in the pre-eclampsia
malondialdehyde (MDA), protein carbonylation group.
PC), protein bound sialic acid (PBS) and ultra
sensitive C-reactive protein (us-CRP)were Conclusion: Oxidative stress synergizes with
compared between 30 controls and 30 pre- inflammation in pre-eclampsia, which increases
the disease severity.
eclampsia cases.
Abstract No: 13.2
Antioxidant Activity of Fermented Tea (Kombucha)
U. Satyanarayana and T. Srihari.
Department of Biochemistry, Siddhartha Medical College, Dr. NTR University of Health Sciences,
Vijayawada, Andhra Pradesh. – 520008. [email protected]
Objective:Kombucha is a home made fermented
tea that has been traditionally consumed in China
for over 2200 years (Since 220 BC), and is now
being used in many other countries. The claimed
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health benefits of kombucha include in disorders
such as diabetes mellitus, hypertension, cancer,
atherosclerosis, arthritis, constipation, AIDS etc.
The biochemical basis of the health benefits of
Indian Journal of Clinical Biochemistry Supplement, 2009/24
kombucha remains largely unknown. The present
study was undertaken to find out the total
antioxidant activity and total content of phenolic
compounds in the kombucha.
Results: Kombucha exhibited good antioxidant
and free radical scavenging activity, besides the
presence of phenolic compounds. Further, the
antioxidant activity and phenolic compounds
concentration were found to increase with
increased fermentation time. It appears that the
claimed health benefits of kombucha consumption
may be partly related to the antioxidants produced
during fermentation.
Methods: Kombucha was prepared by fermenting
freshly made tea after inoculating with a
previously grown culture of kombucha. The
antioxidant activity of kombucha was determined
by ABTS (2,2’-azinobis-3-ethylbenzo-thiazoline6-sulfonic acid) free radical scavenging capacity Conclusion: Further studies are required to
of kombucha samples on different days (upto 7 identify the nature of antioxidants in kombucha.
days) of fermentation. Total phenolic compounds
in kombucha samples were estimated by FolinCiocalteau method.
Abstract No: 13.3
Health Benefits of Origanum vulgare (a Medicinal Herb) through its
Antioxidant Property.
T. Srihari. U. Satyanarayana and N. Nalini*
Department of Biochemistry, Siddhartha Medical College, Dr. NTR UHS, Vijayawada,
Andhra Pradesh. – 520008, * Department of Biochemistry, Annamalai University, T
amil Nadu – 608002.Email: [email protected]
Objective:The use of medicinal herbs in the
healthcare of humans is centuries old. Oregano
(Origanum Vulgare L.) is widely used medicinal
herb in a treatment of various ailments. The
present study was undertaken to evaluate the
efficacy of oregano by in vivo studies against 1,2dimethylhydrazine(DMH)-induced rat colon
carcinogenesis by estimating circulatory lipid
peroxidation (LPO) and antioxidant status. In
addition, the in vitro antioxidant activity of
oregano was also studied.
Methods: DMH-induced cancer was developed
in Wistar rats. Oregano was orally supplemented
everyday in a dose-dependent manner to different
groups of rats for 15 weeks. Tumour-bearing rats
showed increased LPO in the circulation which
was accompanied by a decrease in
levels of antioxidant enzymes (superoxide
dismutase, catalase etc.), besides reduced
glutathione levels. Oregano supplementation
however, reversed the circulatory LPO and
antioxidant profile in colon cancer bearing rats.
Result:In vitro studies demonstrated that oregano
exhibits good free radical scavenging activity,
besides the presence of phenolic compounds.
Conclusion:The medicinal herb oregano possesses
antioxidant property which was proved by both in
vitro and in vivo studies. This property of oregano
may be involved in the treatment of cancer and
other ailments.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 13.4
Status of Enzymatic and Non-enzymatic Anti-oxidant Systems in Patients with Acute
Ischemic Stroke
J. Sudha Rani
Assistant Professor, Dept of Medical Biochemistry, GVP Biomedical Engineering College for Women,
Visakhapatnam, AP.
Objectives: Oxidative stress is probably involved
in neuronal damage induced by ischemiareperfusion. The present study was designed to
measure the enzymatic and non enzymatic
antioxidant status following acute ischemic stroke
patients with large vessel and small vessel infarcts.
Methods: The study included 72 subjects in which
30 were controls and 42 were acute ischemic
stroke cases. They were diagnosed basing on
clinical manifestations and by CT scan of the brain.
The cases were further divided into 2 groups. The
ischemic stroke patients with large vessel infarcts
(Group-L) and small vessel infarcts (Group-S)
basedCT scan of the brain. Serum enzymatic
antioxidants (superoxide dismutase and
glutathione peroxidase) and the non enzymatic
antioxidants (reduced glutathione, vitamin E and
vitamin C) were estimated in all the subjects by
using spectrophotometer.
Results: Ischemic stroke cases had significantly
lower levels of enzymatic and non enzymatic
antioxidants, compared to controls which is
statistically significant (p<0.05). The Group L
ischemic stroke cases had statistically significant
(p<0.05) lower levels when compared to Group S
ischemic stroke cases.
Conclusion: The antioxidant activity of serum may
be an important factor providing protection from
neurological damage caused by stroke-associated
oxidative stress. The present study suggest that
reduced antioxidant status may be used as an
indirect evidence of oxidative stress induced
neuronal damage in acute ischemic stroke which
may be useful for monitoring and optimizing
antioxidant therapy.
Abstract No: 13.5
Oxidative Protein Damage in Thyroid Dysfunction
Dr. Sweta Shivshanker1 and Dr. Anushre Prasad2
Tutor, 2Assistant Professor, Department of Biochemistry, Kasturba medical college, Manipal- 576104
Email address: 1 [email protected], 2 [email protected]
1
Objective: To determine plasma oxidative protein Patients were classified based on T3, T4, TSH
damage in patients with thyroid dysfunction.
measurements.
Methods: 50 hypothyroid patients (mean age
44.6±2.1); 40 hyperthyroid patients (mean age
44.75±2.6) and 50 patients with euthyroid goiter
(mean age 37.2±1.6) were included in the study.
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Plasma protein thiols, protein carbonyls,
erythrocyte glutathione and glutathione reductase
activity were measured spectrophotometrically to
determine the oxidative protein damage. Plasma
Indian Journal of Clinical Biochemistry Supplement, 2009/24
protein thiols were measured after oxidation with
Ellman’s reagent, plasma protein carbonyls
measured with DNPH; erythrocyte glutathione
measured with DTNB and glutathione reductase
activity in haemolysate expressed as activity
coefficient.
hyperthyroid patients was 11.74±0.09 mg/g Hb
which was elevated, when compared to Euthyroid
patients (10.147±0.11 mg/g Hb) [p<0.001].
However, erythrocyte glutathione levels were
significantly lower in hypothyroid patients
(8.72±0.07 mg/g Hb) [p<0.001]. Glutathione
reductase expressed as activity co-efficient in
hyperthyroid patients was 1.47±0.01 and in
hypothyroid patients was 1.23±0.01. The activity
co-efficient was increased in both the groups when
compared to controls (1.009±0.03) [p<0.001]
which indicated a significant reduction of the
antioxidant capacity.
Results: There was decrease in protein thiol levels
in hyperthyroid patients (114.15±2.0 nmoles/ L)
and hypothyroid patients (145.8±2.7nmoles/ L)
when compared to Euthyroid controls (244.06±3.1
nmoles/ L) p<0.001. Protein carbonyl levels in
hyperthyroid patients (1.938±0.03 ng/mg protein)
and hypothyroid patients (1.707±0.02 ng/mg
protein) were elevated when compared to Conclusion: Both hyperthyroidism and
euthyroid controls (1.013±0.01 ng/mg protein) hypothyroidism is associated with oxidative
[p<0.001]. Erythrocyte glutathione levels in protein damage in plasma.
Abstract No: 13.6
Auto Antibodies against Oxidized Low Density Lipoproteins and Lipid Peroxidation
in Patients with Essential Hypertension
K.Ramalingam *, K.Santha †, S.Sethupathy † and R.Vinoth Kumar *
* Department of Biochemistry, Narayana Medical College and Hospital, Nellore ,A.P, † Division of
Biochemistry, Raja Muthiah Medical college and Hospital, Annamalai University, Annamalai Nagar,
TamilNadu.
Background: Lipid peroxidation has been
suggested to play a key role in the oxidative
modification of LDL (oxd-LDL) which stimulate
the production of auto antibodies by B-cells and
anti-oxd LDL antibodies are produced. These
antibodies could represent a biological marker of
oxidative stress and serve as markers of
atherosclerosis. Essential hypertension is a major
risk factor for atherosclerosis, recently border line
hypertension also has been shown to be a risk
factor for atherosclerosis. The aim of this study is
to examine the correlation between oxd -LDL
antibodies and lipid peroxidation in patient with
essential hypertension.
healthy individuals (n=60) levels of Malonaldihyde
(MDA), Total cholesterol, Triglycerides, HDL and
LDL were estimated by spectrophotometry and
levels of Oxd- LDL antibodies were obtained by
ELISA.
Results: Plasma levels of MDA, anti-oxdLDL
antibodies, Total cholesterol and LDL Cholesterol
is higher in patients than those in controls. Among
patients concentration of MDA, total cholesterol
and LDL cholesterol were not significantly
different, however the concentration of anti-oxd
LDL were higher in essential hypertensive patients
(p=0.003). Significant positive correlation was
observed between plasma levels of MDA, total
Methods: Blood samples were collected from cholesterol, LDL cholesterol and the concentration
patients with essential hypertension (n=55) and of anti-oxdLDL in patients but not in the controls.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Conclusion: High concentrations of anti-oxdLDL
suggest an increase in oxidative stress that would
contribute to the development of atherosclerosis.
The observed correlation of MDA with anti-
oxdLDL may suggest a possible pro-oxidative
activity of MDA in patients with essential
hypertension.
Abstract No: 13.7
Oxidative Stress and Insulin Resistance in Type-2 Diabetes Mellitus
R.Viswakumar, K.Ramalingam and R.Vinoth Kumar
* Department of Biochemistry, Narayana Medical College and Hospital, Nellore ,A.P
Background: Diabetes mellitus (DM) is a
metabolic disorder characterized by
hyperglycemia with disturbances in carbohydrate,
fat and protein metabolism. Hyperglycemia may
cause increased production of free radicals, leads
to oxidative stress results in cardiovascular and
Reno vascular complications. Recent studies
demonstrate the reactive oxygen species interfere
with insulin signaling cascades which leads to
resistance to the insulin action . The present study
was aimed to study the relation between insulin
resistance and oxidative stress.
antioxidant power(FRAP), serum creatinine,
fasting plasma glucose and postprandial plasma
glucose
were
estimated
spectrophotometrically.The levels of fating of
insulin were estimated by ELISA. Insulin
resistance was calculated by standard formula.
Methods: Blood samples were collected from
patients with type-II DM (n=50) and healthy
individuals (n=30) levels of Malonaldihyde
(MDA), reduced glutathione,Ferric reducing
Conclusion: The study conclude that the insulin
resistance is associated with oxidative stress.
Antioxidants supplements in type-2 diabetes
mellitus may reduce the associated complications.
Results: Statistical analysis of the results shows
MDA and insulin resistance were increased
significantly in the patients when compared to
control subjects. Reduce glutathione and FRAP
were decreased in patients than the controls..
Abstract No: 13.8
Lipid Profile and Glucose Tolerance Test in Cholelithiasis
R.N Devaki and H.S. Virupaksha
Asssistant Professor, Department of Biochemistry, J.S.S Medical College, S.S Nagar, Mysore-570015
Karnataka, E-mail : [email protected]
Background: Cholilithiasis is a common disease
of gallbladder characterized by gall stone
formation.It is associated with abnormalities in the
relative concentrations of the major biliary lipids
like cholesterol and phospholids.
of cholelithiasis with altered glucose tolerance.
Methods: The study was carried out on patients
with cholelithiasis. A total 50 patients were
taken for the study, among which 35 were female patients and 15 were males. (Age range –
Objective: 1.To study the association between 30 to 70 years). An equal number of age and
serum lipids like total cholesterol, LDL choles- sex matched healthy subjects formed the conterol, HDL cholesterol, triglycerides and trol group. Patient’s fasting venous blood was
cholelithiasis.2.To study the possible association drawn for the determination of total cholesterol,
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
HDL-cholesterol, LDL – cholesterol, triglycerides and for fasting blood glucose. A venous
blood sample was also drawn after 2 hours of a
dose of 75g of oral glucose, to perform glucose
tolerance test.
Results : There was significant increase in the
total cholesterol, triglyceride and LDL- cholesterol
in patients with cholelithiasis when compared to
the control groups. There was significant increase
in blood glucose level in female patients but it was
not significant in male patients.There was signicant
decrease in HDL-cholesterol levels.
Abstract No: 13.9
Association of Hypoalbuminemia with Size of Pleural Effusion in Pneumonia.
Mrs Ranjita V. Gaur and Dr (Mrs ) Rita M. Shah
Email : [email protected], [email protected]
Objective: The objective of this study was to
assess association of hypoabluminemia & pleural
effusion & to propose a possible patho-physiologic
mechanism.
Methods: The Study group consisted of patients
who had presumed bacterial pneumonic
complicated by pleural effusion and admitted to
Dhiraj General Hospital from March 2004 to April
2006. The Volume of Pleural fluid was assessed
semi quantitatively & categorized as small,
moderate or large. The following laboratory results
were recorded for the study: complete blood count,
ESR, Serum electrolyte level, renal & liver
function tests, albumin & protein levels. The
finding were compared with age & gender, who
had matched persons bacterial pneumonic without
pleural effusion.
Results: Of the 75 patients in the study group
23(31%) had small effusion, 24(32%) had
moderate effusion and 28(37%) had large effusion.
Moderate to severe hypoabluminemia was found
in patients 52% of the study group 6% of the
patients with pneumonic without pleural effusion.
Means serum albumin level was lower in patients
with large pleural effusion than in patients with
small effusion (2.66+/- 0.37 vs 3.66+/-0.47 g/dL).
There was no evidence of albumin loss or
significant malnutrition. Estimation of the amount
of albumin in the drained pleural fluid suggested
an albumin shift from blood to pleural fluid.
Conclusion: The Significant hypoabluminemia is
common with patient of parapneumonic pleural
effusion. Large effusion are associated with low
serum albumin levels, which might be explained
in part by a shift from blood to the pleural fluid.
Abstract No: 13.10
Biochemical Effects of Feeding Diglycerol Disulphide in Rats Fed Ethanol or High
Fat Diet
Blessy M. I., Vinod P., Praveen K. V., Sheeba V., J. K. Mukkadan and P. K. Joseph
Little Flower Institute of Medical Sciences and Research, Angamaly 683 572, India.
Email ID: [email protected]
Objective: Aliphatic sulphur compounds are
implicated as the active ingredients in garlic and
onion which have medicinal properties. However
they are not acceptable to many because of the
harsh taste or smell or because of religious tabor.
Hence we have synthesized a synthetic aliphatic
disulphide, diglycerol disulphide and tested its
biochemical effects.
Methods: Thioglycerol was treated with iodine to
get diglycerol disulphide. It was extracted with
ether. After evaporating the ether, light yellow oily
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
liquid obtained had a feeble smell of garlic and ethanol such changes were ameliorated. Similarly
taste was not harsh. This was fed to rats along similar changes produced in serum, liver and
with ethanol or high fat diet.
kidneys by feeding a diet containing 30% dalda
could also be prevented by feeding daily 10mg
Results: When 3ml 30% ethanol was fed to fasting diglycerol disulphide per 100g body weight.
rats, triacyl glycerol, total cholesterol were raised
in liver, kidney and serum. Also AST, ALT and Conclusion: Diglycerol disulphide could be useful
ALP of the serum were raised. When such rats to produce hypolipidemic effects and to protect
were fed 10mg diglycerol disulphide along with the liver similar to garlic.
Abstract No: 13.11
The Prevalence of Celiac Disease in Patients Presenting with Gastro-intestinal
Symptoms
Satinder Kaur, APS Narang, Navpreet Kaur and Indu Verma
Department of Biochemistry Dayanand Medical Collage & Hospital, Ludhiana, Punjab
Objective: Celiac disease is inherited, an auto
immunologically mediated intestinal intolerance
to wheat protein gliadin Celiac disease is
associated with chronic gastrointestinal symptoms
and malabsorption of nutrients causing weight
loss, metabolic bone disease and anemia.
the period of ten months were included in the study.
Patients were divided into four age groups of 05,5-14,14-40 and > 40 years.
Result:Anti ttg IgA levels were estimated using
ORGENTEC diagnostic kits. 16.3% patients were
found to be positive. Females (55%) are affected
Methods: The early diagnosis of celiac disease is more than males.
a set of blood test to measure autoantibodies
especially anti tissue trance glutaminase (ttg) IgA Conclusion:Maximum number of patients
3000 male and female patients visiting out patient detected positive are in age group of 14 to 40 years.
department (Medicine, Gastrentology, pediatric) Serological screening can be highly useful in
of Dayanand Medical Collage and Hospital over detecting sub clinical cases of celiac disease as well.
Abstract No: 13.12
Jun N-Terminal Kinase (JNK) mediates Dextran Sodium Sulfate-Induced Tight
Junction Barrier Dysfunction in Caco-2 Cell Monolayers.
Geetha Samak1 and Radhakrishna Rao2,
DVS College of Arts and Science, Shimoga, Karnataka, India, 2 Professor, Department of Physiology,
University of Tennessee, Memphis, TN. Email ID: [email protected]
1
Objective: JNK /SAPK (Stress activated protein
kinase) activation plays an important role in the
intestinal inflammation in patients with
inflammatory bowel disease (IBD), ulcerative
colitis and Crohn’s disease. Several types of stress
and allergens disrupt intestinal epithelial barrier
function and enhance mucosal permeability. The
312
major component of mucosal barrier function is
epithelial tight junctions (TJs) and therefore, stressinduced inflammatory diseases are likely to be
initiated by the disruption of TJs and induction of
barrier dysfunction.
Methods: Dextran sodium sulfate (DSS)-induced
Indian Journal of Clinical Biochemistry Supplement, 2009/24
murine colitis is widely used model for human
colitis/IBD. We investigated the role of JNK in
mediating the DSS-induced disruption of barrier
function in Caco-2 cell monolayers. Barrier
function was evaluated followed with the exposure
to 2% DSS by measuring transepithelial electrical
resistance (TER) and inulin flux. TJ integrity was
assessed by confocal microscopy. Role of JNK
in DSS-induced TJ disruption was determined by
inhibiting JNK activity by SP600125. Tyrosinephosphorylation of TJ proteins was determined
by immunoprecipitation and immunoblot analysis
.
redistribution of occludin and ZO-1 from the
intercellular junction into the intracellular
compartment. DSS rapidly increased the level of
phosho-JNK. Pretreatment with SP600125
significantly attenuated DSS-induced decrease in
TER, increase in flux and redistribution of TJ
proteins. DSS-induced tyrosine-phosphorylation of
TJ proteins was inhibited by the pretreatment of
SP600125.
Conclusion: These studies indicate that DSS
disrupts tight junctions of Caco-2 cell monolayer
by JNK activity dependent mechanism which
involves tyrosine-phosphorylation of TJ proteins
Result: DSS-induced decrease in TER, increase and redistribution TJ proteins from the intercellular
in inulin permeability was associated with the junction.
Abstract No: 13.13
Storage Stability Characteristics of Hepatobiliary Enzymes in Cattle and Buffalo
Divya P.D.* and K.K. Jayavardhanan**
MVSc Scholar, ** Associate Professor, Department of Veterinary Biochemistry, College of Veterinary
and Animal Sciences, Mannuthy, Thrissur- Pin 680651
Email: [email protected]
Results: The study revealed significant differences
in the storage stability characteristics of each
enzyme in both species at different times and
temperatures. The investigation recommended 4
ºC as the ideal storage condition for preserving
sera samples of cattle for ALT assay, as it was
unstable at freezer, while both 4 ºC and -20 ºC
for buffalo serum. Storage of serum at 4 ºC and 20 ºC was suitable for AST assay for cattle whereas
buffalo serum showed maximum stability in the
serum kept at 4 ºC. The study suggested that ALP
assay should be performed on the day of
venipuncture itself in both species as the enzyme
showed wide variations upon storage. The storage
Methods: Blood samples were collected from of serum both at 4 ºC and -20 ºC was ideal for
eight adult healthy cattle and buffalo, maintained GGT assay in buffalo whereas 4 ºC was
at University farms, Mannuthy. Aliquot of serum recommended for cattle serum.
were assayed for ALT, AST, ALP and GGT
Conclusion: It is therefore advisable to consider
activities after storing at room temperature (25 ºC), stability of serum hepatobiliary enzyme activity
4 ºC and -20 ºC for definite time intervals up to of each species separately for a more valid and
two weeks post collection.
reliable result.
Objective: Although modern analysers can
process samples at a rapid rate, when blood
samples are collected in large numbers or when
many different analysis are required, it is
inevitable to store the sera samples and do the
analysis on a later date. In veterinary medicine,
to date very little has been published on the
stability of serum enzyme markers during
preservation. The study described here was
designed to find out the ideal storage condition
for preserving sera samples of cattle and buffalo
for the analysis of hepatobiliary enzymes like ALT,
AST, ALP and GGT.
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Abstract No: 13.14
IL-6 is a Reliable Independent Biochemical Marker for Predicitng Severity of Acute
Pancreatitis
G.Vasantha lakshmi * Pradeep Naik * B. Prem sagar* B. Vijay Kumar** and K.Ravindranath**
*Dept of Biochemistry, **Dept of Gastroenterology, GLOBAL HOSPITALS, Lakidikapool,
HYDERABAD-500004,
Background: There are several biochemical 1261 kit, with a cut-off of 380 pg/ml. The final
markers that have been used in an attempt to outcome of the patients in terms of severity of
predict the severity of acute pancreatitis. There is pancreatitis viz; mild or severe were noted.
lack of clinical data in Indian population.
Results: There were 21 patients with severe acute
Objective: We performed this study in a tertiary pancreatitis and 32 were mild cases. The mean ILreferral care hospital and aimed at assessing the 6 was 540.57 (SD 761.82). Bivariate analysis
reliability of IL-6 as an independent marker in showed IL-6 to be significantly higher in severe
predicting severity of acute pancreatitis.
pancreatitis. The sensitivity, specificity, PPV, NPV
and AUROC of IL-6 in predicting severe acute
Methods: A total of 53 patients were included in pancreatitis was 90, 94, 90, 94% and 0.9539
the study. All patients who met the specified respectively.
clinical and biochemical criteria of acute
pancreatitis and those who presented within 72 Conclusions: IL-6 is a very accurate and reliable
hours of the onset of symptoms were included in independent biochemical marker for predicting
the study. IL-6 was measured in all these patients severe acute pancreatitis.
on admission. We used IL-6-EASIA-CE KAP
Abstract No: 13.15
Peritoneal Fluid and Bblood Lactic Acid Levels in Acute Abdominal Disorders
A.P.S. Narang, S Goyal*, Indu Verma, Satinder Kaur and J.S. Multani*
Department of Biochemistry and Surgery*, Dayanand Medical College & Hospital,Ludhiana, Punjab
Objective:The present study was aimed to find
the predictive value by comparing the lactic acid
level in the peritoneal fluid and is the blood of
patients with acute abdomen.
Methods:Lactic acid was estimated in peritoneal
fluid and blood in fifty patients with acute
abdominal conditions
blood lactic acid in patients with surgical abdomen
was 3.85+2.96 mmol/l as compared to 4.36+4.34
mmol/l in patients with non-surgical abdomen. The
peritoneal fluid lactic acid levels were significantly
higher in patients with gangrenous gut, perforation
of hollow viscous and secondary peritonitis. There
was no significant difference in blood lactic acid
in two groups. Peritoneal fluid lactic acid levels
were significantly higher than the blood lactic acid
in patients with surgical abdomen.
(30 patients with surgical abdomen and 20
patients with non-surgical abdomen) by Blood Gas
Analyzer. The mean peritoneal fluid lactic acid
values in patients with surgical abdomen was Results: The determination of peritoneal fluid
14.65+6.54 mmol/l and in patients with non- lactic acid concentration particularly when
surgical abdomen was 5.92+4.34 mmol/l and the compared with blood lactic acid levels, is
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
potentially useful in the patients who presented is most beneficial when the patient’s neurologic
with acute intra-abdominal pathology.
status or unresponsiveness hampers the standard
clinical evaluation and in the clinically ill medical
Conclusion:Although its usefulness would be patients in whom a negative laparatomy might in
limited in patients with clear clinical indications itself be catastrophic.
for urgent laparatomy, this diagnostic maneuver
Abstract No: 13.16
Estimation of Serum Enzymes in Antibiotic Therapy for Assessment of
Hepatotoxicity
Sen S*, Sinha S**,Nazmi A ***,Tripathi S**** and Prashant****
Dept of Pharmacology & Biochemistry,Index Medical College,Indore, Madhya Pradesh, *Asst.
Professor, Dept. of Pharmacology;**Demonstrator,Dept of Biochemistry,***Asst. Prof;**** Asso.
Prof,Dept of Pharmacology,Index Medical College,Indore,MP-452016.
Objective: To elucidate the effect of antibiotics
that are causing hepatotoxicity and to assess the
relationship between parameters in the patients of
antibiotic therapy.
Methods: Blood samples were collected after
overnight fasting for 12 hrs and serum were
separated within one hour in admitted patients who
were on antibiotic therapy for more than 14 days
in various departments of Index Medical College
Hospital & Research Centre, Indore. Exclusion
criteria: patients with preexisting liver disease,
chronic alcoholics, history of acute hypotension,
malaria parasite toxicity were excluded from this
study. Based on activity of transaminase enzymes
the patients were divided into two groups. 42
patients who developed hepatotoxicity were in
Group 1 and remaining 35 patients who did not
report heptotoxicity were in Group2. Parameters
(AST, ALT, ALP & LDH) were estimated in semi
auto analyzer (EBRA) using suitable standard
methods & correlated with normal reference values
using suitable statistical method (‘t’ test).
Results: Group1 patients(n=42) shows antibiotic
toxicity with mean values were AST 100.8± SD
66.79, ALT 117.6± SD 110.7, ALP 154.4±SD 42.48
,LDH 178±45.9.Whereas group2 patients(n=35)
with no hepatotoxicity have shown mean values
of AST 36.51± SD 7.35, ALT 40.7± SD 6.42, ALP
122.5±SD 13.4 ,LDH 144±38.1.
Conclusion: Present study was done to assess
antibiotic induced hepatotoxicity by measurements
of the serum liver enzymes and necessity of dose
adjustment among those patients.
Abstract No: 14.1
Phytochemical Investigation and Anthelmintic Activity of Extracts of Seeds of
Elletaria cardamomum
A.A Bidkar, M. K. Aswar*, K.N. Gujar and C. S. Patel
Sinhgad Institute of Pharmacy, Narhe, Pune-411041(M.S) Email ID: [email protected],
[email protected]
Background: Elletaria cardamomum is a widely with wide ranging biological activities. It is used
acclaimed acclaimed Ayurvedic medicinal plant in treating various gastrointestinal, cardiovascular
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
and neuronal disorders. It is attributed with
antimicrobial activity, gut modulatory, blood
pressure lowering, diuretic and sedative activities.
A literature survey revealed that the anthelmintic
activity has not been evaluated so far hence
residues. Preliminary Phytochemical screening of
extracts revealed the presence of Flavanoids,
alkaloids, fats & oils and tannins. Both the extracts
were subjected to screening for anthelmintic
activity on earthworms
Objective: of the present work was to evaluate
these activities of the extracts of the seeds of the
plant
Results; The methanolic extract showed a
significant anthelmintic activity as compared to
albendazole and aqueous extract.
Methods: The coarse powder of the seeds of
E.cardamomum were defatted with petroleum
ether and subjected to continuous hot water
extraction using with methanol and water. The
extracts were filtered and concentrated under
reduced pressure to obtain the extracts as solid
Conclusion: Hence from the results of
Phytochemical and pharmacological; investigation
it can be concluded that, methanolic extract shows
more significant anthelmintic activity compared
to aqueous extract and Albendazole.
Abstract No: 14.2
Phytochemical Investigation and Pharmacological Evaluation of Extracts of Leaves
of Calotropis procera Linn.
A.A Bidkar, K.N. Gujar, U.S. Bagul* K.S.Kanugo and K.J. Oza
Sinhgad Institute of Pharmacy, Narhe, Pune-411041(M.S), Email ID: [email protected],
[email protected]
Background:Calotropis procera (R.Br) is a
widely acclaimed Ayurvedic medicinal shrub with
wide ranging biological activities. It is used
generally for its emetic, anti-inflammatory,
diuretic, anthelmintic, analgesic well as hepatoprotective properties. Very commonly used in
asthma, piles and skin diseases.
presence of Flavanoids, Steroids and tannins. Both
the extracts were subjected to screening for
locomotor activity and anxiolytic activity.
Results: Locomotor activity and anxiolytic activity
was ascertained on white albino mice using
Actophotometer model and elevated plus maize
model respectively. The alcoholic extract showed
Objective:A literature survey revealed that the the depression in locomotor activity, due to
CNS controlled locomotor activity and anxiolytic increase in the GABA concentration in the brain,
activity has not been evaluated so far. Hence more than the Diazepam and aqueous extract.
objective of the present work was to evaluate these Similarly the alcoholic extract showed greater
activities of the extracts of the leaves of the plant. anxiolytic activity as compared to aqueous extract
and Diazepam
Methods: The shade dried leaves of C.procera
were defatted with petroleum ether and subjected Conclusion:Hence from the results of
to continuous hot water extraction using with phytochemical and pharmacological investigation
it can be concluded that, alcoholic extract shows
alcohol (95% v/v) and water. The extracts were
more significant CNS depressant activity in the
filtered and concentrated under reduced pressure
form of locomotor activity as well as anxiolytic
to obtain the extracts as solid residues. Preliminary
activity compared to aqueous extract and
Phytochemical screening of extracts revealed the
Diazepam.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 14.3
Phytochemical Investigations and Anticonvulsant Activity of Seeds of Brassica
campestris.
A. Bidkar*, K. N. Gujar, P. S. Parmar, A. A. Deshpande and A.V. Vaidya
Department of Pharmacognosy*, STES’s Sinhgad Institute of Pharmacy, Narhe, Pune- 411 041 (MS)
India, Email ID: [email protected], [email protected]
Objective: Pentylenetetarazole (PTZ) induced and duration of PTZ induced seizures in more than
seizures in albino mice were used to study 50% of mice.
anticonvulsant activity of aqueous, chloroform and
alcoholic extract of seeds of Brassica campestris. Results: The standard anti-epileptic drugs
(diazepam, phenytoin) however, significantly
Methods An aqueous, alcoholic and chloroform antagonized seizures induced by PTZ. The
extracts were administered intra-peritoneally (i.p) alcoholic extract significantly depressed the central
at doses of 250mg/kg in the experimental model nervous system. The pharmacognostic evaluation
and the effects were compared against PTZ of seeds of Brassica campestris was also carried
induced seizures in standard, control, respectively. out. Preliminary phytochemical studies revealed
Amongst these extracts the alcoholic extract of the presence of alkaloids, flavonoids and tannins.
seeds of Brassica campestris at dose of 250mg/
kg showed significant protection against PTZ Conclusion:The results obtained in this study
induced seizures. The extract delayed the onset indicate the presence of anticonvulsant activity of
alcoholic extract of seeds of Brassica campestris.
Abstract No: 14.4
Anticarcinogenic Effect of Indigofera Aspalathoides by Influencing Xenobiotic
Enzyme Activity During DMBA Induced Hamster Buccal Pouch Carcinogenesis
Philips Abraham, V. Arul and Dr.S.Sethupathy
Animals were sacrificed after 14 weeks. Phase I
(Cytochrome p450, Cytochrome b5 and
Cytochrome b5 reductase) and phase II
(Glulathione-s-transferase, Quinone reductase and
UDP-glucuronyl transferase,)Xenobiotic enzyme
activity of oral tissues were assayed. Tissue
expression of Cytochrome p450B1(CYP1B1),Aryl
hydrocarbon receptor(AHR) and
Aryl
hydrocarbon nuclear translocator (AHNT) were
Methods: Syrian Golden hamsters were divided analyzed by RT-PCR.
in to 4 groups. The right buccal pouch of animals
in Group I & II were painted with 0.5% DMBA Results: All hamsters painted with DMBA alone
3 times a week for 14 weeks. Group II also developed buccal pouch cancer. Phase I enzyme
received an oral dose of ethanol extract of IA (300 activity was observed to be elevated and phase II
mg/Kg body wt). Group III was treated with the enzyme activity was found to be decreased in this
extract alone. Group IV served as the control. group. Administration of IA extract has prevented
Objective: Research for new drugs in the field of
Oncology has been refocused on natural products
-particularly from the plants that is being used as
Folk medicine. This study evaluated the
anticarcinogenic effect of extract from the leaves
of Indigofera Aspalathoides(IA) - which is
traditionally used to treat various skin disorders
and cancer.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
carcinogenesis with a significant decrease in phase
I enzyme and an increase in phase II enzyme
activities.
Conclusion:From the above observation, we
propose that influence of IA extract on xenobiotic
enzyme activity may be considered as one of the
factor for its anticarinogenic property.
Abstract No: 14.5
Biochemical Changes of Feeding Nigella sativa to Rats Fed a High Fat Diet and
Treated with Adrenaline
Bini Balakrishnan, Ceema Varghese, Nithi Varghese, Vidya A B, Praveen K V, Sheeba Varghese,
J K Mukkadan and P K Joseph
Little Flower Institute of Medical Sciences and Research, Angamaly 683 572, India. Email ID:
[email protected]
and moderate reduction in the levels of blood
glucose and liver lipids. When nigella was fed
along with HFD there was reduction in liver and
serum lipids, serum AST, ALT and ALP and blood
glucose. When rats fed HFD and nigella was
Results: Rats fed a diet containing 40% dalda treated with the hormone, the adrenalin induced
(HFD) exhibited higher levels of total cholesterol rise in serum enzymes was much less. Also the
and triacylglycerol in liver and serum, liver levels of serum and liver lipids were less than in
thiobarbituricacid reactive substances (TBARS), HFD fed rats in spite of adrenaline treatment.
serum levels of AST, ALT, and ALP and reduced
levels of serum albumin. When HFD fed rats were Conclusion: Nigella sativa is cardioprotective and
treated with 2 mg adrenaline per Kg, there was hepatoprotective.
phenomenal increase in serum AST, ALT and ALP
Objective: Nigella is a plant used in ayurveda and
its seeds are considered to be cardioprotective and
hepato-protective. To study this, the present study
was undertaken.
Abstract No: 14.6
Biochemical Changes of Feeding Desmodium gangeticum to Rats Fed a High Fat
Diet and Treated with Adrenaline
Ceema Varghese, Bini Balakrishnan, Nithi Varghese, Vidya A B, Praveen K V, Sheeba Varghese,
J K Mukkadan and P K Joseph
Little Flower Institute of Medical Sciences and Research, Angamaly 683 572, India;
Email ID: [email protected]
Objective: Desmodium is a plant used in
ayurveda and extracts of its roots are considered
to be cardioprotective and hepatoprotective. To
study this, the present study was undertaken.
Results: Rats fed a diet containing 40% dalda
(HFD) exhibited higher levels of total cholesterol
and triacylglycerol in liver and serum , liver
318
thiobarbituricacid reactive substances (TBARS),
serum levels of AST, ALT and ALP, and reduced
levels of serum albumin. When HFD fed rats were
treated with 2 mg adrenaline per Kg, there was
phenomenal increase in serum AST, ALT and ALP
and moderate reduction in the levels of blood
glucose and liver lipids. When desmodium was
fed along with HFD there was reduction in liver
Indian Journal of Clinical Biochemistry Supplement, 2009/24
and serum lipids, serum AST, ALT and ALP, and
blood glucose. When rats fed HFD and
desmodium were treated with the hormone, the
adrenaline induced rise in serum enzymes was
much less. Also the levels of serum and liver lipids
were less than in HFD fed rats in spite of adrenaline
treatment.
Conclusion: Desmodium gangeticum is
cardioprotective and hepatoprotective
Abstract No: 14.7
Comparative Study of Jamun Powder and Tulsi Leaf Powder as Hypoglycemic and
Hypolipoidemic Agent in Diabetes Mellitus Type 2
Dr. Meena Verma1, Deependra Sharma,1 Dr. Sangeeta Paneri1 and Dr.A.Mishra2
1 Dept. of Biochemistry M.G.M. Medical College Indore.
2 Dept. of Biochemistry SAIMS Medical College Indore
Objective: A study was done to evaluate the Results: The comparative study has shown
hypoglycemic and hypolipoidemic effects of significant value in between control and study
group. After comparison of both supplements
jamun seed powder and tulsi leaf powder.
jamun powder and tulsi leaf powder in study group,
Methods: Among the 60 obese and diabetic jamun powder have shown highly significant value
subject of 35 years to 55 years. 10 were taken as in serum glucose and significant in serum lipids,
healthy control and 25 diabetic and obese were but the tulsi leaf powder has shown significant
treated with jamun seed powder and 25 were values in serum glucose and non significant in
treated with tulsi leaf powder. The criteria of serum lipids as compared to jamun seed powder
inclusion of study group in subjects was FBS > group.
110 mg/dl of glucose, >290 mg/dl of cholesterol,
> 210 mg/dl of triglyceride, <30 mg/dl of HDL, Conclusion: This study shows that jamun seed
and > than 180 mg/dl of LDL. All the subjects powder is more effective in lowering of serum glucose
were examined for serum glucose and serum lipids. as well serum lipids than the tulsi leaf powder.
Abstract No: 14.8
Nyctanthes arbortristis Extract Restores the Cartilage Damage During Experimental
Arthritis
Brijesh Rathore, A A Mahdi, B N Paul*, P N Saxena**, Farzana Mahdi# and S K Das##
Department of Biochemistry and Rheumatology##, King George’s Medical University, Lucknow,
#
Department of Biochemistry, Era’s Lucknow Medical College, Sarfarazganj, Hardoi Road, Lucknow
226 003, *Immunobiology Laboratory, Industrial Toxicology Research Centre, M. G. Marg, Lucknow,
**Deparment of Zoology, Dr. B R Ambedkar University, Agra.
Objective: Rheumatoid arthritis is an autoimmune
disease, characterised by progressive cartilage and
bone destruction. Normal synovium is a delicate
tissue, lining the joint capsule but in arthritic
condition, the synovium transforms into an
aggressive tumor like structure called pannus,
which invades and erodes the joint. In later stages,
the presence of macrophage, fibroblasts, mast cells
and chondrocyte accumulation is found at the site
of cartilage erosion. However, the pathogenesis of
disease is unclear but activated synovial fibroblasts
appear to play a major role in disease. It is
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
speculated that their ability to induce and
perpetuate inflammation is associated with the
production of pro-inflammatory cytokines which
inturn results in inflamed synovium.
Methods: Arthritis was induced in mice by
injecting the Freund’s Complete Adjuvant in the
foot pad. A booster dose was given on the day
12 th . Nyctanthes arbor tristis extract was
administered orally from the day of induction of
disease.
Results: On the day 47th animals were sacrificed
and the ankle joint was processed for the
histopathology. Infiltration of inflammatory cells,
neovascularisation and cartilage damage was
found negligible in the extract treated animals as
compared to the arthritic one. The cell lining was
also observed intact in Nyctanthes arbor tristis
extract treated animals as compared to the control
animals.
Conclusion:Our findings open up new herbal
therapeutic approach for rheumatoid arthritis.
Abstract No: 14.9
Polyherbal Anti Diabetic Drug: an Approach to Cure Diabetes
Gaikwad SB*, Bhagwat VR* and Trivedi DJ **
* Dept of Biochemistry, SBH: Govt.Medical College, Dhule, ** Dept of Biochemistry, SDN Medical
College, Dharwad .Email: [email protected]
Background: In the last few years the herbal
medicine and drugs are gaining popularity,
because of their natural origin and less side effects
compared to modern synthetic chemical
compounds. To date, over 400 traditional plant
treatments for diabetes have been reported,
although only a small number of these have
received scientific and medical evaluation to
assess their efficacy. There are several mechanisms
through which these herbs act to control the
glucose level, majority of the actions remains
unexplored. The purpose of this study was to
evaluate the possible hypoglycemic actions of a
polyherbal mixture of 17 ingredients which are
commonly used as food and in other herbal
treatments.
Objective: The present study was designed to
investigate the effect of a polyherbal drug, on
blood glucose, glycosylated haemoglobin and
insulin level in alloxan-induced diabetic rats.
Group 1: normal rats given 2 ml of saline; group
2: normal rats given aqueous solution of drug (0.25
g/kg of body weight); group 3: diabetic control
rats given 2 ml of saline; group 4: diabetic rats
given aqueous solution of drug (0.05 g/kg of body
weight); group 5: diabetic rats given aqueous
solution of drug (0.10 g/kg of body weight); group
6: diabetic rats given aqueous solution of drug
(0.20 g/kg of body weight) and group 7: diabetic
rats given aqueous solution of Metformin (500 µg/
kg of body weight). The treatment was given for
30 days. After the treatment, fasting blood glucose,
plasma insulin and glycosylated haemoglobin were
determined in normal and experimental animals.
Results: Treatment with drug resulted in a
significant reduction in blood glucose,
glycosylated haemoglobin value, but plasma
insulin level did not show any significant change.
Conclusions: The present investigation indicated
that the polyherbal drug has shown significant
Methods: Male Wistar rats, body weight of 160- control on the blood glucose level. The herbal
200 g (10 normal and 25 diabetic rats), were used combination could be decreasing the insulin
in this study. The rats were divided into seven resistance thereby increasing the uptake of glucose
groups after the induction of alloxan diabetes. In by cells, resulting into lowering of the glycosylated
the experiment, five rats were used in each group. haemoglobin value and blood sugar level.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 14.10
Extraction and in vitro Evaluation of Biological Activity of Crude Polyphenolic
Extracts from Indian Grapes (Vitis vinifera) on Transformed (AW13516) and Nontransformed (HaCaT) Stratified Epithelial Cells.
Neha Tamhankar (a), Geeta Ibrahim (a), and Milind Vaidya (b)
(a) College of Home Science, Nirmala Niketan, New Marine Lines, Mumbai-40002
(b) ACTREC (Advanced Centre for Research and Education in Cancer), Kharghar,
Objective: Cancer being one of the leading causes
of mortality in the world, preventive measure is
the most cost effective long term strategy for
combating the disease. Recently, naturally
occurring polyphenolic antioxidants obtained
from fresh fruits and vegetables have been
identified as potential chemopreventive agents.
Due to lack of substantial data about crude
polyphenolic extracts from Indian grapes, this
study was carried out to evaluate the biological
activity of the extracted polyphenols on stratified
epithelial cell lines (HaCaT and AW-13516).
Methods: The grape varieties selected for the
study were namely Pandhari sahebi (PS) and
Thompson seedless (TS). The crude extracts were
analysed for their polyphenol content as well as
antioxidant activity using gallic acid as the
standard.
Results: The polyphenolic content of both the
varieties were around 1.5mgs gallic acid / gm
freeze dried powder but the seed showed a very
high polyphenol content and IC50 value was 78µg/
ml. Sulphorhodamine B assay was carried out on
the transformed (AW-13516) and non transformed
(HaCaT) cell lines and it was found that PS
polyphenolic extract was more effective as
compared to the TS polyphenolic extract in causing
cell growth inhibition. Also the effect seen was
greater on the transformed cell line as compared
to the non - transformed. A rapid assessment survey
was undertaken in order to know the awareness of
grape polyphenols among consumers and it was
seen that about 69% of the consumers were
unaware of polyphenols and hence there is a need
to spread awareness regarding the same.
Abstract No: 14.11
Beneficial Effects of Tetrahydrocurcumin and Chlorogenic Acid on Lipid Profile in
Streptozotocin-Nicotinamide-Induced Diabetic Rats
Karthikesan. K and Pari. L
Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University,
Annamalainagar-608 002, Tamilnadu, India.
Objective: The present study investigated the
effect of tetrahydro curcumin (THC) and
chlorogenic acid (CGA) on lipids, lipoproteins and
lipid metabolizing enzymes in streptozotocin
(STZ)-nicotinamide (NA)-induced diabetic rats
were examined.
intraperitoneal (i.p) injection of STZ (45 mg/kg
b.w) 15 minutes after the i.p administration of NA
(110 mg/kg b.w). Diabetic rats showed a significant
(p<0.05) increase in the levels of lipids
(cholesterol, triglycerides (TGs), free fatty acids
(FFAs) and phospholipids (PLs)) in plasma and
tissues (liver and kidney).
Methods: Diabetes was induced in experimental
rats weighing 180–220 g, by a single Results: The plasma levels of low-density and very
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
low-density lipoproteins (LDL and VLDL
respectively) were increased, whereas the levels
of high-density lipoproteins (HDL) were
significantly decreased (p<0.05). The activity of
3-hydroxy 3-methylglutaryl Coenzyme A (HMG
CoA) reductase was increased significantly
(p<0.05) in liver and kidney and the activities of
lipoprotein lipase (LPL) and lecithin cholesterol
acyl transferase (LCAT) decreased significantly
(p<0.05) in the plasma of diabetic rats. Oral
treatment of THC (80 mg/kg b.w) and CGA (5
mg/kg b.w) to diabetic rats for 45 days produced
a significant (p< 0.05) decrease the concentration
of plasma and tissue lipids. Lipoprotein levels were
restored to near normal levels. The activity of
HMG CoA reductase decreased in the tissues and
the activities of plasma LPL and LCAT increased
significantly (p<0.05) in THC and CGA treated
diabetic rats.
Conclusion: These results showed that THC and
CGA supplements seem to be beneficial for
correcting the lipid profile and preventing diabetic
complications.
Abstract No: 14.12
Search for a Perfect Diet Including Antioxidants
Prof (Dr) Kaushal K.Srivastava*
12/4B, Aravali View Rail Vihar, Sector56, Gurgaon (Haryana) *Advisor and Consultant, Pharma
Industries, President, DelhiChapter ACBI, Emeritus Professor, ACBR, Delhi University, Delhi-110007.
Email: [email protected]
Diet pattern of a population depends largely on
the traditions, availability of food items,
agricultural and fruiticultural output. Due to
globalization, easy storage and transportation the
products from one corner of the world are available
all over. Yet, the search for a perfect diet continues
especially with reference to promotion of health
and prevention of chronic life style diseases such
as cardiovascular diseases, cerebral strokes,
neurological disorders, diabetes and even some
type of cancers. A large number of studies have
been made on the role of various food components
like simple and complex carbohydrates, saturated,
unsaturated fats, and fibers in food, minerals and
water in connection with the incidence of chronic
life style diseases. The results have lead to
confusing recommendations from time to time.
The role of free radicals induced damage and its
prevention by antioxidants has been widely
322
described in these conditions. Sometimes
increased intake of antioxidants has resulted in
increased incidence of disease which it intended
to prevent such as carotene and smoking induced
lung cancer. More often, the intake of antioxidant
supplements such as Vitamin E, C and Polyphenols
including Flavanoids had little effect.The search
for a perfect diet continues unabated to promote
health and prevent ageing and disease.
References:
Jonathan Scheff (2008) Scintific American
June 6.
Trivedi,Bijal (2006) New Scientist.
September 23, 42-47
The Good, The Fad, The Unhealthy
Martin, Lisa (2006) New Scientist. August 5, 40-47
The antioxidant myth
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 14.13
Antioxidant Evaluation of Some Hepatoprotective Medicinal Plants
Chorge Ketan, , Dr. (Mrs.) Kale K. U. and Chorge Ulka
The Institute of Science, 15 Madam Cama Road, Fort, Mumbai-32.
Email: [email protected]
Objective: Hepatitis is well known common liver
dysfunction all over the world. There are different
types of jaundice like Infectious hepatitis,
Obstructive jaundice, Alcoholic hepatitis, Malerial
hepatitis; Drug induced jaundice, Cirrhosis of
liver, Viral hepatitis (A to G). It is generally due
to long-term alcohol abuse, infection, or exposure
to various chemicals and drugs. A condition
characterized by yellowness of skin and eyes,
mucous membranes and body fluids due to
deposition of bile pigment resulting from excess
bilirubin in blood (hyperbilirubinanemia). Some
allopathic medicines are known to cure hepatitis.
However, their recovery is very slow and having
side effects of their own. Literature reviews reveal
that the herbal medicines are found to be more
effective for different types of liver dysfunction.
Hence, herbal medicines provide a wide scope in
attempting cure and treatment of liver dysfunction,
in general known as jaundice. Active principles
extracted from plants like phyllanthus niruri,
silybum marium etc. are showed to be effective
against liver dysfunction. Herbs have pronounced
hepatoprotective activity and would be useful tool
in controlling and treating jaundice. An attempt
was done to do comparative study of extraction,
identification, separation and characterization of
herbal active principles from medicinal plants and
to compare the characteristics.
Methods: The present study involves isolation of
phyllanthin a metabolite from the plant of
phyllanthus niruri and silymarin from silybum
marium and comparison of antioxidant activity of
the total extract with the isolated compounds. The
antioxidant
activity
was
compared
spectrophotometrically using DPPH.
Results: The results reveal good antioxidant
activity as compared to standard used ascorbic
acid.
Abstract No: 14.14
Does Chilli Affect Platelet Aggregation?
Kiran DK Ahuja, Murray J Adams, Dominic P Geraghty and Madeleine J Ball
School of Human Life Sciences, University of Tasmania, Launceston, Australia
[email protected]
Objective: Two separate studies were conducted absence and presence of capsaicin and
to investigate the concentration/dose effect of dihydrocapsaicin (final concentration, 3.125 – 100
chilli (capsaicin) on platelet aggregation under in µmol/L).
vitro and ex vivo conditions.
Study 2: Fourteen participants undertook five
Methods: Study 1: Venous whole blood was meal-challenge tests, each in a random order.
collected from six healthy subjects (aged 23-39 Meals comprised of bread, meat patty and a
years) into 3.2% sodium citrate containing glucose drink. Three of the five meals also
anticoagulant tubes. Platelet rich plasma (PRP) contained 20, 30 and 40g of chilli paste,
was separated and aggregation induced with respectively. One meal included capsules filled
adenosine diphosphate (ADP; 5 µmol/L) in the with dry chilli powder. The other meal was a
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
placebo. PRP separated from citrated plasma
collected at fasting and 40 and 120min
postprandially was subjected to ADP (2.5, 5 and
10 µmol/L) induced platelet aggregation.
Study 2: Intake of all five meals resulted in a
reduced maximum platelet aggregation at 120min
postprandially compared to the fasting samples
(p<0.05). The three meals containing chilli paste
resulted in further inhibition of platelet aggregation
compared to the bland (placebo) and the chilli
capsule meals.
Results: Study 1: Concentration-dependent
decreases in ADP-induced platelet aggregation
were observed with both capsaicin and
dihydrocapsaicin (0 vs 100 µmol/L) for max % Conclusion: Chilli (capsaicin) helps inhibit
aggregation and % area-under-curve (all p<0.05). platelet aggregation, a risk factor for
cardiovascular disease.
Abstract No: 14.15
Antidiabetic Effects of the Aqueous Extract of Fruit of Withania Coagulans in
Diabetic Albino Rats
Kirtikar Shukla, JK Gambhir and Rimi Shukla
Department of Biochemistry, University College of Medical Sciences and G.T.B. Hospital, Shahdara,
Delhi-110095; E.mail: [email protected]
Objective: Diabetes mellitus is a clinical
syndrome characterized by a common phenotype
of hyperglycemia and dyslipidemia with
subsequent derangement of carbohydrate, Lipid
and protein metabolism. Fruit of Withania
coagulans is used in the traditional Indian system
of medicine for the treatment of diabetes mellitus.
Our aim was to investigate the hypoglycemic and
hypolipidemic effects of aqueous extract of fruits
of Withania coagulans in alloxan induced diabetes
mellitus in rats.
Methods: Diabetes was induced by intraperitoneal
injection of alloxan at dose of 100mg/kg b.wt. Rats
weighing 150-200gm were divided into three
groups of six each, Group I healthy control, Group
II diabetic control and Group III Diabetic rats
treated with Withania coagulans at dose of 250
mg/kg b.wt./day orally for 30 days.
324
Results: The Group II, rats showed increased
fasting & postprandial blood sugar, serum
cholesterol, triacylglycerol levels and decreased
level of HDL as compared to Group I. Treatment
with water extract of Withania coagulans,
significantly decreased fasting and postprandial
glucose levels in group III as compared to group
II diabetic control rats (p<0.05). Serum cholesterol
and triacylglycerol levels also decreased
significantly in diabetic treated rats as compared
to group II (diabetic rats) (p<0.05), while HDL
level increased as compared to Group II diabetic
control rats (p<0.05). Glycosylated hemoglobin
(HbA1c) was 8.79 in diabetic group which
decreased to 5.9 in WC treated group While GHb
A1c of healthy control was 4.65.
Conclusion: These results show that water extract
of fruit of Withania coagulans has potential to be
used in the treatment of diabetes mellitus.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 14.16
A Putative Anticancer Mechanism of Plant Derived Polyphenols
∗
Mohd. Fahad Ullah, Uzma Shamim, Sarmad Hanif, Asfar S Azmi, Showket H Bhat and S.M.Hadi∗
Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh 202002,
India; Email : [email protected]
Nutraceuticals are defined as food or parts of food
that provide medical or health benefits including
the prevention or treatment of diseases. Many
plant derived foods and beverages contain the
class of nutraceuticals known as polyphenols. As
such plant polyphenols are important constituents
of human diet and a number of these are
considered to possess chemopreventive and
therapeutic properties against cancer. They are
recognized as naturally occurring antioxidants but
also act as prooxidants catalyzing oxidative DNA
degradation in the presence of transition metal ions
such as copper. Using human peripheral
lymphocytes and Comet assay we have shown that
polyphenols are capable of causing cellular DNA
breakage. Incubation of lymphocytes with
neocuproine (a cell membrane permeable Cu (I)
chelator) inhibited DNA degradation confirming
that Cu (I) is an intermediate in the DNA cleavage
reaction. Bathocuproine, which is unable to
permeate through the cell membrane, did not cause
such inhibition. Further we have shown that
polyphenols are able to degrade DNA in cell nuclei
and that such DNA degradation is inhibited by
neocuproine as well as bathocuproine (both of
which are able to permeate the nuclear pore
complex) but not by compounds that specifically
bind iron and zinc (desferrioxamine mesylate and
histidine respectively). Copper is a major metal
ion present in nuclei and it is well established that
tissue, cellular and serum copper levels are
considerably elevated in various malignancies.
Therefore cancer cells may be more subject to
electron transfer between copper ions and
polyphenols to generate reactive oxygen species.
Such a common mechanism would better explain
the anticancer effects of polyphenols with diverse
chemical structures as also the preferential
cytotoxicity towards cancer cells
Abstract No: 14.17
A Comparative Study of Nitric Oxide and Hydrogen Peroxide Scavenging Activities
of Botanical Extracts Ocimum sanctum and Wagatea spicata.
Geetha Samak1, Revathi P Shenoy 2 and D. M. Vasudevan 3
1
DVS College of Arts and Science, Shimoga, Pin 577201, Karnataka, India , 2 Department of
Biochemistry, Kasturba Medical College, Manipal University, Manipal Pin 576104 Karnataka, , 3
Professor of Biochemistry and Chairman Amrita laboratory service, Amrita school of Medicine, Amrita
Vishwa Vidyapeetham, Cochi -682041, Kerala.
Objective: Ocimum sanctum, a traditional
medicinal plant of India, showed significant
abilities of scavenging superoxide, hydrogen
peroxide radicals and inhibiting lipid
peroxidation. Wagatea spicata, a medicinal plant
found in Western Ghats of India is also potent
scavenger of highly reactive superoxide and
hydroxyl radicals.
Methods: In the present study we evaluated Nitric
oxide(NO) and Hydrogen Peroxide(H 2 O 2 )
scavenging abilities of the plants in comparison
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
with known antioxidant Ascorbic acid. Shade dried
plant material powder was extracted with water,
fractionated with different solvents. Total phenolic
and flavonoid content of the plant materials were
analyzed through spectrophotometry. NO was
generated from sodium nitroprusside and
scavenging action was measured by the Greiss
reduction. H2O2 scavenging action was measured
by peroxidase based assay system.
5 ± 1.4µg /ml, 6.5 ± 2.9µg /ml respectively which
is almost equal to that of ascorbate. Wagatea
showed significant NO scavenging action than
ocimum. Flower and bark extracts, their methanol
and water fractions of Wagatea showed NO
scavenging activity having IC50 at 10 ± 7µg/ml.
Free radical scavenging action of Wagatea spicata
and Ocimum sanctum can be correlated with its
phenolic and flavonoid rich plant materials.
Results: Botanical extracts of both the plants
showed concentration-dependant inhibition of
H2O2 and NO. Ocimum leaves showed better
scavenging of H2O2 than Wagatea. Crude extract
of Ocimum showed IC50 at 18.5 ± 6.2µg/ml,
ethyl acetate and diethyl fractions having IC50 at
Conclusion: These results indicate that both these
plants can scavenge deleterious NO and H2O2
radicals at low concentration. Phenolic and
flavonoid rich Ocimum and Wagatea can be
supplemented as antioxidant equivalent to
ascorbate.
Abstract No: 14.18
Cardioprotective Effect of Terminalia arjuna on Isoproterenol Induced Myocardial
Infarction in Rats
S.K. Shukla*, S. Dwivedi**, U.R. Singh*** and S.B. Sharma*
Department of Biochemistry*, Department of Medicine and Preventive Cardiology**, Department of
Pathology***, University College of Medical Sciences (University of Delhi), Delhi -110095.
Objective: Cardiovascular diseases are one of the
leading cause of morbidity and mortality in
developed as well as in developing countries,
therefore its prevention is a major public health
challenge. Oxidative stress plays a potential role
in CAD and it has been reported to accelerates
atherosclerosis. Terminalia arjuna is traditionally
used for the treatment of heart diseases.
Methods: The present study was undertaken to
demonstrate the effect of hydroalcoholic extract
of Terminalia arjuna bark on lipid peroxidation,
reduced glutathione and superoxide dismutase to
evaluate the antioxidant activity in experimentally
induced myocardial infarction in rats and then
sacrificed for histopathological investigation.24
male albino rats weighing 200-250g were divided
into three groups (n=8 in each groups).Healthy
control (groupI) were given normal saline for 30
days. Isoproproterenol treated rats(groupII) was
given normal saline for30 days, Isoproterenol
326
(85mg/kg b.w) administered Subcutaneously on
29th and 30th day. To drug treated rats (groupIII)
hydroalcoholic extract of T. arjuna (HETA), orally
administered for 30 days at a dose of 100 mg/kg
b.w, Isoproterenol administered SC on 29th and
30th day. Fasting blood samples were taken prior
to and after given the treatment to estimate MDA,
GSH and SOD, and then sacrificed for
histopathological examination.
Results: HETA produced significant depletion in
MDA with a concomitant elevation in activity of
SOD. GSH level was also significantly increased
by HETA (p< 0.001).Histopathological studies
showed area of necrosis in isoproterenol treated
rats.
Conclusion: The results suggest that crude bark
of TA augments endogenous antioxidant
compounds of rat heart and also prevents oxidative
stress associated with Isoproterenol induced
ischemia.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 14.19
Aluminum Induced Changes in Blood and Brain; Protective Role of Bacopa
monnieri
Sandeep Tripathi1, Abbas Ali Mahdi1, Mahdi Hasan2, Deepa Prajapati3, Sanjay Annarao3, Raja
Roy3 and C. L. Khetrapal3
Departments of 1Biochemistry and 2Anatomy, C.S.M. Medical University, 3Centre of Biomedical
Magnetic Resonance, SGPGIMS Campus, Lucknow -226014.
Objective: Comparative therapeutic efficacy of
Bacopa monnieri extract (BR) and anticholinergic
drug donepezil (DP) on aluminum (Al)
neurotoxicity have been investigated using
Magnetic Resonance Imaging - Magnetization
Transfer Contrast (MRI-MTC) imaging,
correlative behavioral, biochemical and ultra
structural investigations of rat brain followed by
metabolic changes in serum and urine and blood
biochemistry.
Results: Large accumulation of age pigment
lipofuscin granules, macroautophagy in
hippocampus of Al3+ treated rats as observed in
the Electron microscopy (EM) images indicates
early aging and its similarities with Alzheimer
disease, which reflects its direct correlation with
lower MTR value. Significantly elevated value of
MTR following 90 days co-administration of
Brahmi when compared with Al3+ and DP treated
rats.
Methods: In the present study, male albino rats
were administered with AlCl3 (100 mg / kg body
weight) for 90 days and simultaneously treated
another groups with 40mg and 2.5 mg / kg body
weight with Bacopa monnieri and Donepezil
respectively. Serum and urine was used to asses
the markers of metabolic disturbances followed
by the behavioral and MRI-MTC imaging of rats.
Furthermore, ultrastructural changes were also
evaluated in the hippocampus.
Conclusion: On the basis of the results of the
present study, we conclude that Al may be
responsible for neurolipofuscinogenesis and
alteration in neurobehavioral activity and these
changes may be responsible for the development
of age related diseases like Alzheimer’s disease
and Bacopa monnieri might be used as
neuroprotective agent.
Abstract No: 14.20
Hypolipidemic Activity of Hibiscus rosa sinensis (root) in Hyperlipidemic Rats
Vishnu Kumar 1, Ranjana Singh 3, Sushma Singh 3, Shivani Pandey 3, Ashok Kumar Khanna 2,
Ramesh Chander 1,Pradyumn Singh1, Farzana Mahdi 1, Jitendra Kumar Saxena 2, Vinod Kumar
Singh 3 and Raj Kumar Singh 3
1
Department of Biochemistry & Pathology, Era’s Lucknow Medical College &Hospital, Lucknow226003, ,2 Division of Biochemistry, Central Drug Research Institute, Lucknow-226001, and 3
Department of Biochemistry, Chhatrapati Shahuji Maharaj Medical University ( Formerly King
George’s Medical University ), Lucknow- 226003.
The hypolipidemic activity of Hibiscus rosa extract has been studied in triton and cholesterol
sinensis (family Malvaceae; Hindi name Gudhal, rich high fat diet (HFD) fed hyperlipidemic rats.
Japa in Sanskrit and shoe flower in English) root In triton WR-1339 induced hyperlipidemia,
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
feeding with root extract (500mg kg-1 b.w.)
exerted lipid lowering effect as assessed by
reversal of plasma levels of total cholesterol:TC
(22 %), phospholipids:PL (19 %) and
triglyceride:TG (22 %) following reactivation of
Post Heparin Lipolytic Activity:PHLA (11 %). In
another model, chronic feeding of this natural
product (500mg kg-1 b.w.) in animals
simultaneously fed with high fat diet for 30 days
caused lowering of lipid levels in plasma TC (20
%), PL (23 %), TG (20 %), reactivation of PHLA
(16 %) and in liver homogenate decrease in TC
(21 %), PL (23 %), TG (24 %) with stimulation of
hepatic lipolytic activity 17 %. The hypolipidemic
activity of Hibiscus rosa sinensis root was
compared with a standard drug guggulipid (200mg
kg-1 b.w.), a known lipid lowering drug in both
models. Histopathology of liver in rats fed with
cholesterol rich diet showed microvesicular
steatosis and occasional macrovesicular in zone 3
(perivenular area) of hepatic lobules along with
sinusoidal dilation and mild congestion and the
portal trials revealed mild increased in
inflammatory infiltrate
comprising of
mononuclear cells and neutrophils. The liver
histopathology in rats which simultaneously also
received Hibiscus root extract showed only mild
feathery degenerative changes and mild vascular
congestion but no steatosis Kupfer cell linings the
sinusoids were prominent and increased in number.
Their portal triads showed
increased
inflammatory infiltrate rich in mononuclear cells
admixed with polymorphs and fair number of
eosinophils. The overall hepatic architecture was
maintained.
Abstract No: 14.21
Cholinesterase Activity in Health Workers Involved in Handling and Spraying of
Organophosphorous Insecticides
Himanshu Madaan, Veena Singh Ghalaut and Ashuma Sachdeva
Deptt of Biochemistry, Pt. B D Sharma Univ of Health Sciences, Rohtak, Haryana, [email protected] ; [email protected]
Background:
Anyone
exposed
to
Organophosphorous (OP) pesticides can develop
lowered cholinesterase levels; therefore regular
checking of their AChE levels should be done.
Nearly all the insecticides have the potential to
significantly alter the ecosystem. In humans, they
are responsible for acute poisonings as well as
for long term health effects, Organophosphates
and Carbamates are, nowadays, widely used as
insecticides. These compounds can cause toxicity
through all routes of exposure-dermal, oral,
respiratory and, even, ocular. They exert their
effect mainly by the inhibition of
Acetylcholinesterase (AChE), an enzyme that
328
occurs in the CNS, which functions by removing
acetylcholine (ACh) from its postsynaptic
receptors.
Methods: The present study was conducted on 38
subjects working as Multipurpose Health Workers
(MPHW GROUP-I) and Field Workers (FW
GROUP-II) in District Rohtak, Haryana India to
see the effect of exposure to OP insecticides. Serum
cholinesterase activity was measured by a kinetic
method based on hydrolysis of butrylthiocholine.
Results: The MPHW were involved in storing and
distributing of the insecticides, whereas the FW
were involved in the actual spraying of the
insecticides. The mean cholinesterase activity in
Indian Journal of Clinical Biochemistry Supplement, 2009/24
group- 2 (5410.56+957.66) was lower by 27.76% reduction in the levels of PChE, compared to the
workers involved in only the handling of the
than that in group-1 (7489.28+1106.95).
insecticides indicating that this group is at a bigger
Conclusions: The workers involved in actual
risk. So, the improved controls on workplace
spraying of the insecticides had a more marked
exposure to pesticides should be focused on these
Abstract No: 14.22
individuals.
Lead Poisoning in Residential Areas Near Drainage Systems in Bangalore
Anitha Jerry Juneeja Varghese and Antony.P.U
Under the guidance of Dr. Venkatesh. T
With the accumulation of lead containing
substances in drainage systems, there is a
possibility of this lead-contained water to seep into
the groundwater and to be used by the residents
of the nearby area. In which case, the water might
be able unusable. This was checked by a study
done in a few areas of Bangalore near large
drainage systems. Both bore well and normal well
water samples were collected and tested for their
level of lead concentration. Most results remained
within the prescribed limits, except for a few odd
samples. The variation in the few samples can be
ascribed to the activities in the surrounding areas
and certain human errors that could have occurred
during the course of the sample collection. This
showed that the water used in residential areas near
large drainage systems were free from the harmful
concentration of lead and was safe for use.
Abstract No: 14.23
Study of ADA Levels in Tuberculus and Non tuberculus Pleural Effusion
K. Sravanthi, Dr. B. Prabhakar Rao, Dr. V. Sunanda and Dr. C.N. Prasad
Prathima Institue Of Medical Sicences, Karimnagar, Andhra Pradesh. E.mail :
[email protected]
Objective: To assess the diagnostic level of ADA
in pleural effusion fluid.
Methods: The present study was carried out on
60 patients suffering from pleural effusions of
various etiologies. 40 Patients with history and
clinical examination suggesting of Tubercular
pleural effusion admitted in chest unit of Prathima
Institute of Medical Sciences, Karimnagar where
included in the study & labeled as group – I. In
addition as a control of the study, 20 selected
patients having Transudate pleural effusions
secondary to cirrhosis of liver of Cardiac Heart
Failure etc., are taken as group – II. This selection
criteria was based on history, clinical examination
and by fluid protein estimation to differentiate
exudates from transudate (Lights Criteria). The
ADA activity was compared in both the groups
and a cut of value was set as 40 U/L. The results
were analyzed by applying “Chi Square Test”.
Results: The ADA activity of Group – I was 40.6
+ 9.8 U/L. While that of Group -II was 24 + 10
U/L. The “P” value was < 0.001. The results of
the study favors application of ADA activity in
Pleural Fluid as the diagnostic tool for Tuberculus
pleural effusion without performing any invasive
procedures like pleural biopsy.
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No: 14.24
A Brief Study of Lead Poisoning Among Children
Faculty and Students
Dept. Of Biotechnology, NMKRV College for Women, Bangalore; E-mail id:
[email protected] Ph.No: 080-26643499
Children are more susceptible to lead poisoning
because their bodies are still developing and their
body’s tend to retain more lead than adults. 30
students from Byramangala government school
were tested for blood lead levels. The criteria for
choosing Byramangala as the study area was that
the untreated domestic sewage of Bangalore city,
effluents of various small scale industries are
released into Vrishbhavati River which in-turn
enters the Byramangala reservoir throughout the
year. The water and vegetable samples consumed
by these children were analyzed using Atomic
Absorption Spectrophotometry. Blood lead levels
was analyzed using Anodic Stripping Voltametry
using an ESA 3010 lead analyzer. The atomic
absorption spectrophotometry showed that the
vegetable and water samples had lead levels in
“Below Detection Levels” (BDL) and thus may
be ruled out as possible sources of lead poisoning.
However the results of the blood analysis obtained
remained a cause for concern, as 10% (3 Nos.)
were having high blood lead levels, 27% (8 Nos.)
were on the borderline, indicating the fact that
almost 37% of children have or are on the verge
of lead poisoning. The reasons for such high blood
lead levels needs to be further investigated and
awareness has to be created among the people
living in that area.
References:
a). Chapter 9, AOAC, 18th edition for vegetable
samples.
b). IS: 3025 (P47) - 1994 for water samples.
c) .Anodic Stripping Voltametry using an ESA
3010 lead analyzer.
Abstract No.14.25
Iodine Deficiency Disorders Among the Primary School Children of Eastern Nepal.
Gelal B, Chaudhari R, Nepal A, Das BKL, Lamsal M and Baral N*
*Professor and HOD, Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan,
Nepal . E-mail: [email protected]
Objective: To assess the iodine status among the deficient (UIE <100µg/L) children were 26.6% in
primary school children of eastern Nepal.
Dhankuta and 15.6% in Dharan. In both areas
Methods: A population based cross sectional study majority of children consumed packet salt. The
was conducted on two schools of Dhankuta and percentages of salt samples with adequately
Dharan at January – March. A total of 385 urine iodized salt (e”15 ppm) were 83.3% in Dhankuta
and equal numbers of salt samples were collected and 89.6% in Dharan.
from school children of 6-11 years. UIE was Conclusion: In both areas iodine deficiency is not
measured by ammonium-persulphate digestion a major pubic health problem because of normal
microplate (APDM) method and salt iodine median UIE, consumption of packet salt and
content by semi quantitative rapid test kit.
majority of salt samples were adequately iodized.
Results: The median UIE of school children of But continuous monitoring program must be
Dhankuta and Dharan were 151.13µg/L and continued to ensure the adequate iodine status of
180.34µg/L respectively. The percentage of iodine population
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No.14.26
Role of Plasma Homocysteine Level in Coronary Artery Disease and Stroke- A
Clinical Perspective
*Girish P. Pandey, **Sukhes Mukherjee, **Kannan Vaidyanathan and **D.M Vasudevan
*Department of Medicine, **Department of Biochemistry, Amrita School of Medicine, Kochi
Objective: Homocysteine is a compound formed
in the trans-sulphuration pathway from methionine
via the intermediates S Adenosyl methionine and
S adenosyl Homocysteine. Homocysteine is
commonly associated with various diseases and
its elevated levels are known to be associated with
cardio-vascular disease, stroke, pre-eclamsia of
pregnancy and dementias.
Homocysteine concentrations will be estimated by
ELISA. Estimations of other enzymes like
cystathionine beta synthase, methylene
tetrahydrofolate reductase and methoinine
synthase was also measured.
Results: There was significant elevation of plasma
homocysteine level in acute myocardial infarction
patients when compared with control group. There
Methods: We studied the total Homocysteine was also alteration of the other enzymes studied.
levels in patients selected from our cardiology and
neurology department. 95 patients in each Conclusion: Our data from this study provide
category of CAD and stroke were compared with evidence that plasma homocysteine levels are
105 normal individuals coming to the medicine elevated in patients with acute myocardial
department for routine check up. Total infarction.
Abstract No.14.27
Vitamin B12 and Folic Acid Levels in Tobacco Chewers: A Duration Dependent
Study.
Indira Samal1, M.Maneesh, Sukhes Mukherjee1 and Subir K Das2 .
1
Dept of Biochemistry, Amrita Institute of Medical Sciences, Kochi, Kerala.
2
Dept of Biochemistry, Govt Medical College, Agartala, Tripura.
Background: Cytotoxic effects of chewing
tobacco are mediated through production of
reactive oxygen species. Superoxide dismutase
(SOD) and Glutathione Reductase are antioxidant
enzymes.Vitamin B12 and folate are cofactors in
the synthesis of DNA.Vitamin B12 is also a cofactor
in the synthesis of methionine from homocysteine,
increased levels of which are risk factors for
coronary artery disease and cardiovascular
diseases.
Species and to correlate them with Vitamin B12 and
folic acid levels in tobacco chewers.
Methods: 50 healthy male tobacco chewers aged
30.6 ± 4.7 years with 3 to 10 years (7.37 ± 2.1)
history of tobacco chewing were included in this
study. Twenty-five healthy male volunteers, aged
26.5 ± 4.8 years, served as controls. All the
participants were from the same community and
of similar dietary habits. SOD activity was assayed
by method of Paoletti et.al, GR using Goldberg
Objective: To evaluate the activities of oxidative Spooner method and vit B12 and folic acid.
stress parameters like superoxide dismutase
(SOD) and Glutathione Reductase in view of Results: Decreased erythrocyte SOD and GR level
possible role of the generation of Reactive Oxygen indicates suppressed antioxidant status. A parallel
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
significant decrease in these antioxidant enzymes
along with decrease in vit B 12 and folic acid level
was observed with increase in duration of tobacco
chewing.
Conclusion: These factors studied play an
important role in oral leukoplakia cancers. The
possibility of increase in homocysteine in serum,
which elevates the risk of coronary artery disease
and probably cardiovascular accidents, has to be
studied further. Moreover, providing adequate
quantity of vit B12 and folic acid will prevent
cytotoxic effects of chewing tobacco and has to
be considered as supplementation in the
management of these subjects and while
deaddiction programmes.
Abstract No.14.28
Role of Pro and Anti-inflammatory Cytokines in the Modulation of alcoholic Liver
Disease.
Sukhes Mukherjee* , Subir Kumar Das$, and D.M Vasudevan*
*Department of Biochemistry, Amrita School of Medicine, Kochi-682041
$
Department of Biochemistry, Agarthala Govt Medical College, Kunjaban P.O., Agartala-799006
Objective: Hepatic fibrosis is an outcome of
chronic liver diseases; and alcoholic liver disease
(ALD) is associated with elevated liver
hydroxyproline content in experimental animal
model. Alcohol also mediates clinical diseases by
altering host immune function.
normal subjects. While TNF-α level increased with
severity of ALD, TGF-β1 level increased
significantly in severe stage of ALD patients
compared to moderate and mild stages of ALD.
Though serum hydroxyproline content level
elevated significantly in ALD patients and
Methods: Therefore, we investigated the role of correlated significantly (p<0.01) with every tested
pro-inflammatory and anti-inflammatory parameter, but did not change with severity of the
cytokines on hydroxyproline content in serum of disease.
32 alcoholic subjects, 40 ALD patients and 45 Conclusion: The results indicate that some of the
‘normal’ subjects.
initial cytokines that are produced in chronic ALD
Results: Liver function tests were significantly set the stage for direct a profiled cytokine response
altered in ALD patients. Interleukin (IL)-4 levels either toward a strong proinflammatory Th1
decreased significantly, while IL-6, IL-10, TNF- cytokine response or a profibrogenic Th2 cytokine
α and TGF-β1 levels increased significantly in response and thus regulate fibrogenesis including
ALD patients in comparison to alcoholic and stimulation for hydroxyproline production.
Abstract No.14.29
A Simple Urine Test for Diagnosis and Day to Day Management of Diabetes Mellitus
Dr. M.V. Imbichi Mammi
Former Prof. of Medicine & Research, Government Medical College, Melevallopra, Kovoor, Calicut,
Kerala 673 008. Email: [email protected]
Objective: Most of the diagnostic tests for comfortable to the doctor nor friendly to the
Diabetes Mellitus available today are neither patient. Our objective is to offer a cost effective
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
and hassle-free test to empower patients for single colour varied in proportion to the glucose
management, prevention and even cure of the concentration.
disease.
Conclusion: It is found that the renal threshold
Methods: We have experimented and modified for glucose is around 150mg% and not 180mg%
the use of GOD/POD solution for estimating the as argued earlier. Painful, costly and invasive blood
glucose in urine. Through further trials we have glucose estimation is no more necessary. The
simple urine test empowers the patient for
succeeded to standardise the new test.
diagnosis and day to day management of DM. It is
Results: Even 1 mg% of glucose was detected by Cheap, simple, hassle free and is best suited for
auto analyser and 10 to 15% of the Benedict’s -ve mass screening.
cases were shown to be +ve. The intensity of the
Abstract No.15.1
Antidiabetic Activity of a Coastal Mangrove, Rhizophora mucronata Poir. : Effect
on Carbohydrate Metabolism in Alloxan-induced Diabetic Rats
K. Desigamanib, S. Manivannan*, K Kathiresana and T. Ramanathana rita mary arunab
Centre of Advanced Study in Marine Biology, Annamalai University, Parangipettai-608502, Tamil
Nadu. bAssistant Profesor, Department of Biochemistry, Vinayaka Mission Medical Collage & Hospital,
Salem-636308, Tamil Nadu. Email: [email protected]
a
Results: Oral administration of RBEt (120 mg kg1
) modulated all the above parameters to normal
level. A comparison was made between the actions
of RBEt and commercial antidiabetic drug
glebenclamide (0.1 mg Kg-1) and the effect of RBEt
(120 mg kg-1 ) was near to commercial drug,
Methods: Three different concentrations (30, 60, glibenclamide.
120 mg kg -1) for 30 days on blood glucose,
haemoglobin (Hb), glycosylated haemoglobin Conclusion: Our study provided evidence for the
(GHb), some key carbohydrate metabolic enzymes antidiabetic activity of ethanolic RBEt that can also
and liver glycogen in normal and alloxan-induced be extrapolated to clinical studies in future.
diabetic rats were studied.
Aim: The aim of the present study was to
investigate the effect of every day oral
administration of ethanolic extract of a coastal
mangrove plant Rhizophora mucronata bark
extract (RBEt)
Abstract No.15.2
Antitumour Activity of Some Homoeopathic Medicines in Animal Models and
Possible Mechanism of Action
Ramadasan Kuttan, Preethi K.C., Girija Kuttan
Amala Cancer Research Centre, Thrissur, Kerala. Email: [email protected]
Homoeopathic medicines are practiced in many
Western as well as in Eastern countries. Even
though clinical use of homoeopathic medicines
against several diseases has been well documented
its scientific acceptability is still questionable due
to the lack of well carried out clinical trials as well
as evaluation of these medicines in a scientific
manner. Several homoeopathic medicines have
333
Indian Journal of Clinical Biochemistry Supplement, 2009/24
been prescribed in cancer. In the present study we
have evaluated the use of homoeopathic preparation in the laboratory using modern techniques.
Initial studies conducted to find out the cytotoxic
potential of potentiated homoeopathic drugs indicated that the some of the potentiated
homoeopathic medicines produced cytotoxicity to
various cell lines and inhibited T-thymidine uptake. Moreover these preparations were found to
inhibit the tumour development induced by
Dalton’s lymphoma ascites (DLA) cells and
Ehrlich ascites carcinoma cells in mice. Potentiated preparation of Hydrastis was found to cure
the developed tumours in mice produced by DLA
cells. Potentiated homoeo drugs were also found
to inhibit the chemical carcinogenesis induced by
3-methylcholanthrene and nitrosodiethylamine.
Mechanism of action of homeopathic drugs indicated that some of the mother tincture as well as
their potentiated preparation had similar activity.
For example mother tincture of Ruta as well as its
200C potentiated preparation induced chromosomal aberrations and DNA damage in vitro and
in vivo. Moreover some of the preparations were
found to induce apoptosis to tumour cells as seen
in morphology and induction of marker enzymes
as well as by Tunnel assay. This was also substantiated by microarray analysis in which several
genes involved in apoptotic pathway were found
to be elevated by treatment with these preparations. It was also found that some of these preparations induced ROS generation in the cells and
this may be a major initiating agent to induce DNA
damage as well as apoptosis.
Abstract No.15.3
Radioprotective and Chemoprotective Effect of Carotenoid Meso-zeaxanthin
A.P. Firdous and R. Kuttan
Amala Cancer Research Centre, Amala Nagar, Thrissur, Kerala [email protected]
Methods: Radio protective and chemo protective
activities of carotenoid meso-zeaxanthin [(3R,
3’S)-â, â-carotene-3, 3’-diol] were studied using
in vivo mice models. For radio protective study
whole body irradiated (300 rads, single dose)
animals and for chemo protective study, cisplatin
(16 kg /kg.b.wt, ip, single dose) treated animals
were used. Animals were pre treated with different
doses of meso-zeaxanthin (50 and 250 mg/
kg.b.wt, orally) and drug treatment was continued
after irradiation / cisplatin injection and the
animals were sacrificed at different time periods.
Results: Treatment with meso-zeaxanthin
significantly reduced myelosuppression in both
cases as seen from the increased WBC count, bone
marrow cellularity as well as number of maturing
monocytes in the drug treated animals. The levels
of antioxidant enzymes like superoxide dismutase,
334
catalase, glutathione peroxidase as well as
glutathione levels were found to be drastically
decreased after irradiation and cisplatin alone
treatment .The levels were markedly elevated by
meso-zeaxanthin treatment in a dose dependent
manner. Kidney function markers in the serum like
urea and creatinine were increased in cisplatin
alone treated animals and were decreased
significantly by meso-zeaxanthin treatment. The
result of histopathological analysis also support
the chemo protective potential of meso-zeaxanthin.
Conclusion: All these results showed that mesozeaxanthin has profound chemo and radio
protective potential.
Acknowledgment: This work was supported by
a grant from Omni Active Health Technologies Pvt.
Ltd., Mumbai.
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No.15.4
Hepatoprotective Activity of Carotenoid Lutein
Sindhu E R and Ramadasan Kuttan
Amala Cancer Research Centre, Amala Nagar, Thrissur, Kerala. [email protected]
Aim: Carotenoid lutein (3,3’-dihydroxy- â, å- conjugated diene and hydroperoxides in the liver
carotene) was evaluated for its hepatoprotective tissue produced by the administration of
activity in rats.
paracetamol were found to be reduced in lutein
treated groups. The hydroxy proline which is an
Methods: Paracetamol (3g/ Kg body weight, indicator of fibrosis in liver tissue was high in
orally), 20 % ethanol (7.5 g/kg body weight, control group treated with ethanol. Hydroxy
orally) and CCl4 (2.5 ml/kg, ip) were used to proline levels were decreased by simultaneous
induce the liver toxicity.
lutein administration. The antioxidant enzymes like
Results: The level of SGOT, SGPT and ALP SOD, catalase, GPx and glutathione levels in liver
which were increased in the serum was found to tissue were found to be increased in lutein treated
be significantly reduced by the treatment of lutein groups compared with control group during alcohol
50, 100 and 250 mg/kg b.wt in a dose dependent and CCl4 induced liver toxicity.
manner indicating that lutein could reduce
hepatotoxicity induced by paracetamol, ethanol
and CCl 4. The serum bilirubin was also
significantly low in lutein pre-treated groups when
compared with control indicating its protective
role. Moreover albumin globulin ratio was found
to be high in lutein treated groups compared
control groups. Increased lipid peroxidation,
Conclusion: These results substantiate the
hepatoprotective action of lutein which may be due
to its ability to scavenge reactive oxygen radicals.
Acknowledgment: This work was supported by a
grant from Omni Active Health Technologies Pvt.
Ltd. Mumbai.
Abstract No. 15.5
XRCC – 1 Polymorphisms (Arg194Trp and Arg399Gln) in Oral Cancer from a
Kerala Population.
Balaji Natarajan
Background : Oral cancer is one of the leading
cancers in India. In particular, the state of Kerala
has one of the highest incidence of oral cancer in
the world. The status of DNA repairing gene
XRCC1 genotypes Arg194Trp (exons 5, 6) and
Arg399Gln (exons 9, 10) in Oral cancer is to be
determined by the following study.
samples were selected from the repository for this
study. DNA isolated from these samples was amplified using PCR technique. Restriction digestion
of the amplified gene was performed using Pvu II
& Nci I enzymes respectively to detect polymorphisms in the two XRCC 1 genotypes. The patients
were classified into risk groups (cigarettes, betel
quid, pan, alcohol or tobacco) and no-risk groups
Methods : Tissue samples (normal & tumor) were based on their lifestyle.
collected from individuals diagnosed with carcinoma at The Head and Neck Institute. 15 tissue Results: The results so obtained were combined
335
Indian Journal of Clinical Biochemistry Supplement, 2009/24
with the results available in the lab for the purpose of analysis. So, a total of 30 patients were
analyzed. Analysis of exons 5, 6 revealed that only
1 patient was homozygous for Trp194Trp, while
2 (7%) were heterozygous (Arg194Trp) and the
rest (90%) showed the Arg194Arg genotype. Exons 9, 10 analysis indicated that 8 (26%) were
Arg399Gln heterozygous, while none were homozygous for Gln399Gln. Amongst the risk group,
only 6 patients exhibited polymorphism.
Conclusion: Our study showed an increase in the
Arg399Arg heterozygote in our study population,
suggesting a marginally increased risk of HNSCC
associated with this allele, as supported by other
studies, especially in other Asian populations. It
is of much concern that Arg194Arg was seen in
90% of patients. This is in accordance with other
studies that this may be the risk factor.
Abstract No.15.6
Multiple Myeloma, 2008 Statistics
Ramesh K, Riju M, Prasanth G, Sreejith A.S.,
EI Lab Metropolis, North Square, Parmara Road, Opp. To Town Hall, Cochin-18
Email: [email protected]
Aim: The study was carried out to determine the
incidence of Multiple Myeloma in Kerala population and to study the age and sex wise distribution as well as to analyze the type of immunoglobulin.
Methods: Past one year multiple myeloma cases
of all sample received for electrophoresis in the
EI Lab Metropolis Laboratory was analyzed.
Results: Out of the 12000 sample received for
electrophoresis 2.5% were having multiple myeloma band. 70% of which were showing thick M
Band at gamma region while 15 % were between
gamma and beta region and the remaining 15% at
beta region. The male female ration was 1.1 suggesting a slight prevalence of the disease in male
population. Number of case at age below 40 were
very less 1% (100% Male), between 41 and 50
were 9% (60% Male, 40% Female), between 51
and 60 were 21% (43% Male, 57% Female), between 61 and 70 were 32% (41% Male, 59% Female), between 71 and 80 were 27% (58% Male,
42% Female) and between 81 and 90 were 10%
(78% Male, 22% Female)
Conclusion: The incidence of multiple myeloma
in Kerala population may be higher than the national and international 0.8 to 1.2 per lakh. Even
though there is a higher incidence there is no considerable gender difference in this population.
Most of them gives a band in the Gamma region.
Abstract No. 15.7
Auto Immune Thyroid Disease Antibodies
Riju M, Prasanth G, Sreejith A S. Ramesh K,
EI Lab Metropolis, North Square, Parmara Road, Opp. Town Hall, Cochin-18
Email: [email protected]
Aim: The objective is to study the pattern of
thyroid antibodies in thyroid patients of Kerala.
336
Methods: The seven analytes of the thyroid profile
(thyroid stimulating hormone (TSH),
Triiodothyronine(T3), Thyroxine(T4), Free T3
Indian Journal of Clinical Biochemistry Supplement, 2009/24
(FT3), Free T4 (FT4), Thyroglobulin
antibody(ATA) and anti thyroid peroxidase
antibodies (anti-TPO)) were estimated and 218
samples with anti-TPO values above the normal
cutoff of 60 IU/ml were analyzed. All samples
were analyzed using direct chemiluminescence
method on Advia Centaur (Siemens).
Results: 91% of the cases were female while 6%
male and 3% were children. The incidence is
highest during the third decade of life in females
and during the 4 decade in men and then shows a
decline. 77% of the case were having a Anti TPO
values between 60 and 500 and 16% were having
very high titre of more than 1300 IU/ml. Almost
50% of the cases were showing a Normal ATA
level, 32% had an ATA between 61and 250 IU/ml
while 12% showed a high titre of more than 500
IU/ml. 10% of the total were showing a high titre
of both Anti TPO and ATA. The average TSH level
were 5.95.
Conclusion: The incidence of autoimmune thyroid
may be high in Kerala population which needs
demographic studies. Autoimmune antibodies
were predominant in female of reproductive age
group, may be mainly due to the postpartum
hypothyroidism. There is considerable percentage
of high autoimmune titre patients.
Abstract No.15.8
Orocecal Transit Time and Small Intestinal Bacterial Overgrowth in Patients
with Microscopic Colitis
SV Rana, KK Prasad, SK Sinha, S Sharma, J Kaur and K Singh.
Department of Super Specialty, Gastroenterology, PGIMER, Chandigarh
Background: Microscopic colitis presents with
a characteristic clinical feature of chronic nonbloody watery diarrhea. Small intestinal changes
contributing to its pathogenesis and clinical picture have not been extensively studied. There may
be delayed orocecal transit time (OCTT) resulting in small intestinal bacterial overgrowth (SIBO)
in microscopic colitis.
inflammation in the lamina propria with mainly
mononuclear cells, a subepithelial collagen layer
<10 µm or a diffusely disturbed and thickened subepithelial collagen layer >10 µm, increased number of intraepithelial lymphocytes <20 / 100 surface epithelial cells. Orocecal transit time was
measured by non-invasive lactulose hydrogen
breath test and SIBO by glucose hydrogen breath
test. 100 age and sex matched apparently healthy
Aim: Therefore, this study was planned to measubjects were also enrolled.
sure OCTT and SIBO in this condition.
Results: Mean age of patients was 40.5±15.6 yrs
Methods: 54 adult patients with age range 19-75
while of controls 42±17.5 yrs. SIBO was in 7%
yrs, complaining for watery diarrhea, were diagpatients while 1% in controls. Orocecal transit time
nosed for microscopic colitis by Histopathology.
was 112 ± 15.4 minutes in patients and 104.6 ±
Out of 54 patients 42 (77%) were males & 12
12.8 minutes in controls.
(23%) females. Criteria for diagnosis of microscopic colitis was intraepithelial lymphocytes Conclusion: This study indicates that there was
(IEL) >20 / 100 surface epithelial cells, epithelial no significant difference in OCTT & SIBO in padamage such as flattening and mucin depletion, tients with microscopic colitis as compared to controls.
337
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No.15.9
Plasma Myeloperoxidase in Diabetes Mellitus
Usha Anand, Vijaya D, Gayathri B, Aruna V and Anand CV
Department of Biochemistry, PSG Institute of Medical Sciences and Research, Coimbatore-641004.
Email: [email protected]
Objective: Myeloperoxidase (MPO) is an
enzyme normally present abundantly in
neutrophil granulocytes. It has been shown that
MPO serves as a link between inflammation and
cardiovascular disease (CVD). It is known that
endothelial dysfunction develops early in
diabetes mellitus (DM), preceding clinically
detectable atherosclerosis. This study was aimed
at determining the levels of plasma MPO in
patients with an established diagnosis of type 2
DM.
Methods: Plasma MPO was determined in 100
patients with type2 DM and 43 controls by a
spectrophotometric method. HbA1c and plasma
fasting glucose were estimated on Cobas Integra
400 plus autoanalyzer.
Results: Plasma MPO (mean ± SD) was 600.7 ±
566.1 U/L in the DM group and 270.3 ± 156.5
U/L in the control group. It was significantly
higher (p< 0.001) in the DM group as compared
with the control group. There was however, no
statistically significant correlation between plasma
MPO and plasma glucose in both groups. The
HbA1c in the DM group also did not correlate with
plasma MPO in the DM group.
Conclusion : MPO is a pro-oxidant that is released
from the granules of activated neutrophils. It has
been shown to oxidize low-density-lipoproteins
rendering them more atherogenic. It could lead to
the consumption of nitric-oxide causing
endothelial dysfunction. Raised levels of this
enzyme could serve as an indicator of
cardiovascular risk in patients with DM. The lack
of correlation between the glycemic status and
MPO seems to indicate that this enzyme might not
be directly involved in the glycation of
hemoglobin.
Abstract No.15.10
Serum Cystatin C in Various Stages of Chronic Kidney Disease
Krishnamurthy N 1, Usha Anand 2, Anand C.V 2, Aruna V 2 and Venu G 3
1
Department of Biotechnology, Sathyabama University, Chennai, 2 Department of Biochemistry and
3
Department of Nephrology, PSG Institute of Medical Sciences and Research, Coimbatore 641004.
Email: [email protected]
Objective: Serum creatinine (Scr) is routinely
used in order to assess renal function. Serum
cystatin C (Scys) has been proposed as an
alternative parameter for the determination of
glomerular filtration rate (GFR). This present
study was carried out to compare these two
parameters in patients with various stages of
chronic kidney disease.
338
Methods: Scr and Scys were estimated by standard
laboratory procedures. GFR was determined by
99m
Tc- DTPA clearance method (DTPA). The 92
patients were classified according to Scr levels,
mild kidney disease (MIKD) with Scr d” 3 mg/
dL, moderate kidney disease (MOKD) with Scr
value 3.1 – 6 mg/dL and severe kidney disease
(SKD) with Scr value e” 6.1 mg/dL. GFR was
Indian Journal of Clinical Biochemistry Supplement, 2009/24
calculated using the Scr based MDRD formula Conclusion: Scys is more sensitive than Scr for
and Scys based Orebro- Gentian (O-G) formula. the detection of MIKD. This could be attributed
to the fact that cystatin C is excreted exclusively
Results: Scr and Scys correlated significantly (p by glomerular filtration unlike creatinine which is
< 0.001) with DTPA clearances, with r values of - also secreted by the tubules. Scys based O-G
0.609 and -0.779 respectively. The correlation formula performs better than the Scr based MDRD
coefficient between DTPA and MDRD formula formula. Scys should therefore be introduced as a
was 0.744 (p<0.001) while between DTPA and routine parameter in the panel of renal function
O-G formula it was 0.972 (p<0.001). ROC tests and used for the calculation of GFR.
analysis demonstrated an area under curve value
0.970 for Scr and 0.992 for Scys.
Abstract No.15.11
Evaluation of Hyperglycemia, Glucose Intolerance, Hypertension and
Socioeconomic Position in Eastern Nepal
Mehta KD1, Karki P2, Lamsal M1, Paudel IS3, Majhi S1, Das BKL1 Sharma S2 Jha N3 and *Baral N1
Department of Biochemistry1, Internal Medicine2 and Community Medicine3
Objective: To evaluate the association between
urban and rural people in terms of hyperglycemia,
socioeconomic position (SEP) and hypertension
in community based survey in sunsari district of
eastern Nepal.
Methods: Blood glucose levels from participants
(n=2006) e” 30 years of age from urban and rural
population were classified according to WHO
criteria (1998) into normoglycemia (NGY),
impaired fasting glucose (IFG), impaired glucose
tolerance (IGT) and hyperglycemia (HGY)
groups. Moreover, both IFG and IGT is considered
as glucose intolerance. SEP was assessed in a
structured health interview along with
Anthropometric measurements and behavioral
variables. Hypertension was classified as per Joint
National Committee (JNC-VII) criteria.
Results: About 10.26% subjects (urban-13.3% &
rural-11.0%) in this survey had given the family
history of diabetes. Within the participants, who
experienced no past history of diabetes 70(9.51%)
HGY and 143(19.42%) glucose intolerance were
identified in urban population (n=736) and
114(8.97%) HGY and 176(13.85%) glucose
intolerance in rural population (n=1270).
Participants were showed an increasing trend of
hyperglycemia and intolerance with higher age (÷2
198.278, P<0.001), BMI (÷2 35.137, P<0.001), SEP
(÷2 48.55, P<0.001) and Hypertension (÷2 130.63,
P<0.001). Hyperglycemic individuals in urban
relatively higher had an odds ratio 0.706 (95%
confidence interval [CI] 0.455-1.096) relative to
rural population. Individuals having lower and
medium SEP had odds ratio 1.405(CI 0.798-2.474)
and 1.832(CI1.151-2.915) with respect to higher
SEP individuals.
Conclusion: The impact of hyperglycemic and
intolerance conditions on both urban and rural
population are at risk. Individual having medium
SEP has lower risk of diabetes as compared to both
lower and higher SEP.
339
Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No. 15.12
Advanced Research on Heavy Metal Pollution in Ganga Water; Detection with
Integrated Coupled Plasma-Atomic Emission Spectrometry
Ashutosh Kumar Sharma
MBBS Student, Amrita School of Medicine, Kochi.
Aim: The study forms the first report on primary
screening for pH, turbidity, T.D.S.value on heavy
metal poisoning in surface water of river Ganga.
Methods: The values of secondary screening are
measured by ICP-AES instrumentation which has
greater sensitivity than AAS and has relevance
from human health perspectives . A total of 13
surface water samples collected from river Ganga
in Varanasi and Allahabad during 2009 were
analyzed for pH, turbidity and total dissolved solid
(TDS) value. Secondary screening was done for
As, Hg, Fe, Mn, Zn, Cu, Cd, Cr, Pb and Ni. Water
Sample digestion done with nitric acid method.
Results: The pH was found in the alkaline range
(7.11-8.53), T.D.S. value ranged (330-530) while
turbidity was obtained in the range(1-11nTU). Fe,
Mn, Zn,Cu,As,Hg, Cr and Pb were detected in the
samples in the range of 6.066-288.7ppm, 0.160.33ppm, 12.195-985.57ppm, 0.23-0.497ppm,
0.163-0.494, 0.13-0.329ppm, 0.337-4.05ppm,
0.16-0.81ppm respectively. Cadmium was not
detected in any sample. As and Hg were detected
only in few samples (0.001-0.003 and 0.0030.032mg/L).
Conclusion: The dominance of various heavy
metals in the surface water of the river Ganga
followed the sequence: Zn >Fe >Mn > Cr > Cu>
Pb >As > Cd. Zinc an iron were detected with
maximum concentration. Other metals were also
present in toxic range.
Abstract No.15.13
My Experience of Two Decades Using Mid Size Laboratory Automation in Clinical
Laboratory Practice
Dr. Ulhas R. Tendulkar, Director, Ambalab, Goregaon East, Mumbai-400063
A lab practitioner needs around 5 to 7 years to
establish and acquire significant reputation in laboratory medicine. Thereafter it is advisable to think
on laboratory automation. Once this decision is
taken, then mobilization of resources has to follow. Proper selection of equipment, preferred vendor and financial provisions are essential. The
issues like cost benefit ratio, turn around time, in
house training for self and staff needs to be taken
care of. Thereafter, break even ratio and profits
need not be overlooked. I have gone through all
these ordeals over a span of two decades.
340
My personal experience states that 1. Break even
ratio is achieved in 2 to 3 years. 2.Substantial financial returns were obtained after 3 years. 3.Client satisfaction was achieved within one year, on
the pretext that the laboratory has moved towards
latest technological developments. 4.In house
training was completed within two weeks after
installation. 5. Bulk work load could be processed
without increasing staff. 6. Other issues such as
interfacing of equipments, computer networking,
calibration of dispensing system, dispatch of reports could be handled in effective manner. 7. The
Indian Journal of Clinical Biochemistry Supplement, 2009/24
miscellaneous issues such as finance and material management, laboratory administration participation in quality assurance programmes (both
internal and external) could be tackled without
much difficulty.
The limitations of laboratory automation which I
have faced are: 1. Financial repercussions. 2.
Persuasion of the client on cost hike. 3. Equipment maintenance.
Considering above aspects it is still advisable for
an individual laboratory practitioner to opt for automation to keep pace with latest developments in
laboratory medicine. The pros and cons of this
approach will be discussed.
Abstract No. 15.14
Detection of Mitochondrial Point Mutation in Maternal Inherited Diabetes with
Deafness (MIDD) Using Various Molecular Tools
R.R. Kumar, K. Ponsuganthi, S. Selvaraj*, H. Palaniswamy#, B. Mohanty
Department of Biochemistry, AV Medical College, Pondicherry
*Technical Director, Helini Biomolecules, Chennai
#Department of Physiology, AV Medical College, Pondicherry
Background: The prevalence of diabetes mellitus
is very high in urban Indian adults. The literature
have identified a clinical subset where maternal
pedigrees with mitochondrial DNA (mtDNA)
mutations, having diabetes mellitus associated
with sensorineural hearing impairment. This entity
is also known as MIDD. The most commonly
reported such mutation of mtDNA occurs by
substituting guanine for adenine (A-to-G) at
position 3243 of leucine transfer RNA
(tRNALeu(UUR)).
Objective: To identify a molecular tool to detect
the mtDNA mutation much faster, economical and
less labor intensive so as to use it as screening
procedure for relevant patients.
Methods: Before conducting the study we
received the necessary Institutional Ethical
Committee (IEC) clearance certificate, necessary
consent was taken from the patient as well as from
control patient. PCR-RFLP, PCR followed by
allele specific sequencing and PCR-ARMS
technique was used to detect the point mutation.
The PCR product was visualized by agarose gel
electrophoresis. To validate the results both control
and patient sample were send for DNA sequencing.
The sequence data was compared using
bioinformatics tools.
Resulst: We found PCR-ARMS was satisfying our
objective. Successful PCR resulted; a single 475
bp PCR product from control sample and two PCR
products [275bp and 475bp] are observed in test
sample. Validation was done as mentioned above.
Other protocol were laborious, time consuming,
involving many step.
Conclusion: We conclude PCR-ARMS was the
best amongst the three tools for the detection of
point mutation in mtDNA .
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Indian Journal of Clinical Biochemistry Supplement, 2009/24
Abstract No. 15.15
Gold in Human Semen Around and Away from a Gold Deposit Area
Sahab Khan .P, Skandhan K. Pa, Ajesh .K, Siraj M.V.P
Sir Syed Institute For Technical Studies, Taliparamba, Kannur.
a
Azeezia Institute of Medical Sciences and Research, Meeyyannoor, Kollam.
Aim: A study was done to understand the level of
gold in semen among people around and away
from a gold deposit area.
Methods: A total number of 25 semen samples
from a gold deposit area ( Nilambur Valley,
Malappuram district) and 25 from a control area
( Kollam district ) were collected. All subjects
were clinically healthy (20 – 40 years). Semen
evaluation was done as per standard criteria laid
done by WHO. Gold was analyzed in 11 and 13
samples from Nilambur and Kollam respectively
by Inductively Coupled Plasma Atomic Emission
Spectrophotometry at Sophasticated Test and
Instrumentation Centre in Cochin University of
Science and Technology.
Results: Semen study showed all samples fulfilled
the criteria laid down for normal Zoospermia.
Amount of Gold in seminal plasma from
Nilambur valley showed in the range of 0.23 –
1.15 ppm ( Mean 0.68 ppm) and control area
showed 0.13 – 0.71 ppm (Mean 0.41 ppm).
Abstract No. 15.16
Effect of Chilli (Capsaicin)on Oxidation of Serum Lipoproteins
Kiran D.K Ahuja and Madeleine J. Ball
School of Human Life Sciences, University of Tasmania, Launceston, Australia
E-mail: [email protected]
Objectives:Two seperate studies were conducted on fasting serum collected at the end of the two
to investigate the effect of chilli (capsaicin) on dietary periods.
serum lipid oxidation under in vitro and ex vivo
Results : Study 1: Lag time increased and the rate
conditions.
of oxidation decreased (all p<0.05) with increasing
Methoodology : Study 1: Serum collected from concentrations of the capsacinods compared to the
six healthy subjects was subjected to copper- control sample. Study 2: The rate of serum
induced (100 µΜ) oxidation in the absence and oxidation was significantly lower (p=0.04) after
presence of capsaician and of dihydrocapsaicin the chilli diet, compared to the bland diet. Lag time
(final concentrations, 0.1-3 µΜ).Study 2: Twenty was not significantly different between the two
-seven men and women participated in a diets.
randomised cross-over trial where they consumed
a bland (without chilli) or chilli diet for a period Conclusion : Capsaicin and dihydrocapsaicin can
of four weeks. Chilli diet was similar to the bland affect serum oxidation and regular consumption
diet but included 30g of chilli paste each day. oof chilli for four weeks increases the resistance
Copper induced serum oxidation was carried out of serum lipoproteins to oxidation
342
INDEX
Abhraham Pretty Mary: 1.11
Abraham, George:
3.24
Abraham, Philips: 14-4
Abraham, Ransi Ann: 6-6
Acharya, Subraya, K: 8-1
Adams, Murray, J: 14-14
Adhikari, P: 5-25
Adhikari, S: IL-29
Adiga, M.N.S: 9-12
Adiga, Usha: 9-12
Agarwal, B.K: 7-8
Agarwal, Ekta: 7-11
Agarwal, Sunil: 3-28
Aggarwal, A:3.3
Aggarwal, H.K: 3.20
Aggarwal, Juhi: 11-20
Aggarwal, Shakti: 4-9
Agrawal, Aparna: 9-14
Agrawal, B.K: 11-7 ; 12-12; 12-14
Agrawal, B.K: 2-1;2-5:2.12;3-14
Agrawal, B.K: 4-4; 6-4; 6-18; 7-15
Agrawal, Madhur: 12-3
Agte, A.B: 11-1
Ahaley, S.K: 2.27; 2-28; 8-31
Ahmad, Mohd. Kaleem: IL-5
Ahmad, Rizwan: 11-26
Ahmad, Sohail: IL-5
Ahuja, Kiran, D.K: 14-14
Ajeena: 4-22
Akshatha: 11-4
Alagappan, Kannappan: 1.27
Alam, R: 6-12
Alderuccio, Frank: IL-25
Ali, Farha: 2.5
Ali, Syed Hyder: 3.10; 3-17; 5-18
Ali, Z: 4-21
Aliaga, J: IL-46
Amancherla, Rajyalakshmi: 10-20
Ambekar, J.G: 2.21; 2-22
Ambikadevi, K: 2.2
Anand, C.V: 3.1; 3-12; 5-24; I:-54
Anand, Meena: 12-3
Anand, Usha: 3.1; 5-24; IL-55
Anand, Usha: 3.12
Anand, Vinit: 9-16
Anbarasu, K: 8-4
Anbazhagan, M: 4-11
Anbazhagan, M: 6-25; 7-1
Andrews, Liggy: 5-1
Andrews, M.A: 4-17
Anilkumar, Alka: 1.10
Animesh, Kumar: 4-21
Anindita, M: 8-13
Anita: 12-19
Anju T. R: 1.11
Anjum, Javeria: 2.30
Annarao, Sanjay: 14-19
Antony, P.U: 14-22
Anuja, P.S:7-23
Anumesh Pathak, Anumesh: 11-5
Anwar, Naureen: 10-1; 12-1
Anwar, Naureen: 7-16
Arasan, Ezhil, K: 3.19
Archana, E: 6-5; 6-23; 11-4
Arif, N: 6-12
Arivazagan, R: 1.5
Armstrong, V.W: KN-2
Arora, M.M, Brig: O-1
Arora, S: 2.25
Arul, V: 14-4
Aruna, Rita Mary: 3-9; 11-3; 10-5; 10-6
Aruna, S: 8-17
Aruna, V: 3.1 ; 3-12; 5-24
Ashok, Ben, S: 4-11
Asif, A: 5-23
Asmathulla, S: 4-3; 9-7
Aswar, M.K: 14-1
Aswathi, K.I: 1.21
Azmi, Asfar, S: 14-16
Azzi, Angelo: KN-1
Babu Vishal, G.N: 2.4
Babu, Jaiprakash, M: 12.2
Babu, Sreehari, B: 3.6
Babu, Sreehari, B: 8-14
Backstrom, Thomas:
IL-25
Badade, Z.G: 10-19; 11-24; 12-11
Badade, Z.G: 2.27; 2-28; 3-18; 8-31
Bagul, U.S: 14-2
Bahl, V.K: 6-6
Balachander, J: 4-15
Balakrishnan, Bini: 14.5; 14-6
Balakrishnan, V: 1.24
Balambal, R: 6-27
Balasubramanian, M.K: 6-15
Ball, Madeleine, J: 14-14
Bandyopadhyay, Debapriya: 8-5
Bandyopadhyay, Sandip, K: IL-6
Banerjee, Mononjay: 6-22
Banerjee, Rupa: 7-3
Bansal, A.K.: 2.10
Banu, Naheed: IL-7
Baquer, Najma, Zaheer: 10-4
Baral, N: 14-25
Barnard, Ross: IL-2
Bartholomew, F: IL-46
Baruah, Upasana: 11-10
Basak, A: 6-30; 6-31
Baskar, K: 11-9
Baweja, Payasvi: 3.13
Behera, Sudeshna: 5-15
Bernard, Claude, C.A: 9-21; IL-25
Bhadre, Rohini: 3.5
Bhagwat, V.R: 5-22; 9-13; 14-9
Bhagyajyothi, D: 9-11
Bhandari, S: 4-6
Bhandarkar, Meghana: 12-3
Bharat, Vinay: 11-15
Bharathy, N: 12-21
Bhargava, A.K: 3-28
Bhargava, A: 8-26; 8-27; 8-28
Bhargava, S.K: 10-21
Bhargava, S: 6-11; 6-26
Bhargava, Vishal: 4-7; 10-24
Bharti, Sushma: 2.31
Bhaskaranand, Nalini: 1.13; 12-22
Bhat, D.S.: 2.3
Bhat, Gopalakrishna, P: 10-13; 12-5
Bhat, Showket, H: 14-16
Bhat, Srinivas: 10-9
Bhat, V: 3.8
Bhat, Vijay, S: 3-25; 10-25
Bhat, Vinayak, S: 10-25
Bhatt, Surya Prakash: 10-18
Bhattacharjee, Jayasree: O-3; 11-6
Bhattacharyya, Mau: 5-4
Bhattacherjee, Ramakrishna: 6-22
Bhimappa, N.M: 3.4
Bhimte, Bhawna: 4-4; 11-7; 12-14;
Bhutia, Y: 9-5; 11-14
Bidkar, A.A: 14-1; 14-2; 14-3
Bidwai, Ani: 8-15
Bini, B: 5-24
Bitla, Aparna: 4-1; 5-12; 8-17; 12-8
Blackwell, L: IL-56
Blessy, M. I: 13-10
Bobby, Z: 13-1
Bobby, Zachariah: 9-14
Bordoloi, Pranami: 1.8; 12-13
Bowling, W: 6-20
Boyd, Richard, L: IL-25
Brown, Lindsay: IL-23
Burgess, J:
IL-14; IL-52; IL-56
Cariappa, Rohit: IL-40
Casikar, Vidyasagar: IL-6
Chakrabarti, Amit: IL-61.
Chakraborty, Somashree: 5-14
Chakravarthy, M.R: 3-10; 6-1
Chandak, G.R: 10-21
Chander, Ramesh: 14-20
Chandra, Anu: 9-17
Charanra,j T.P: 2.31
Chatterjee, Mitali: IL-27
Chattopadhyay, S: IL-3
Chattopadhyay, Subrata: IL-18
Chaudhari, R: 14-25
Chaudhury, Bikash: 1.8;11-8;12-13
Chauhan, Sarika Singh: 2.12; 6-18
Chavan, M.M: 8-31
Chetana, K: 1.2; 12-4
Chitra, P: 10-6
Choudhary, S.C: 4-14
Chowdary, Radhika, D: 2.33
Chowdhary, Arvindkumar: 9-6
Christudoss, Pamela: 2.8
Cornelissen, G: 11-23
D’souza, F: 10-26
D’Souza,Vivian: 5-25; 9-11;
D’Souza, Vivian: 9-16; 12-6
Dahiya, Kiran: 6-10; 11-17
Dakshinamurthy,Gajalakshmi:8.30
Damodaran, Geetha, K: 4-17
Dandekar, S.P: IL-37
Das, B.K.L: 14-25
Das, Barnali: IL-12
Das, Bidyut Kumar: 8-20
Das, Debashish: 8-10
Das, Dipali: 1-8; 12-13
Das, S: 6-11
Das, S: 6-26
Das, Subir Kumar: IL-18; IL-24
Das, Subir Kumar:14-8;14-27;14-28
Dasgupta: Debjani: 10-15
Dash, Debabrata: 7-20
Datta, Palika: IL-21
Daver, Rekha, G: 6-32
Dawar, Rajni: 4-12
Deepa, K: 12-6
Deepak, Tejeswini: 6-14
Deepthi, K: 8-17
Deindl, Elisabeth: IL-60
Desai, P.B. 1.2; 1-9; 10-17; 12-4
Desai, P.B: 7-12; 7-14; 7-18
Desai, Prakash, B: 8-21
Desai, Prakash: 6-24
Deshpande, A.A: 14-3
Despande, Bm: 11-1
Devaki, R.N:13-8
Devaraj, Sridevi:IL-13
Devaranavadagi, B.B: 2.21
Devaranavadgi, B.B: 2.22
Devi, Ambika: K: 6-16
Dey, Arpi: 2.30
Dhabe, M.G: 4-14
Dhananjayan, K: 3.19; 8-4; 11-9
Dharwadkar, Sm: 11-1
Dhas, Priya, K: 10-5; 10-6
Dhillo, Manjit, Singh: 10-18
Diggle, L: IL-56
Dinesh, M: 12-18
Divya, K.V: 4-22
Divya, P.D: 13-13
Dodawad, Reshma: 12-15
Dohare, Preeti: 10-23
Donde, Uday:IL-11
Dongre, Nilima N: 2.21; 2.22
Dorni , Charles, A.I: 11-19
Doureradjou, P: 12-17
Dr.P.K.Behera, P.K: 3.6
Dr.Shanmugam, S: 2.9
Dubey, Neelam: 11-5
Duffield, A: IL-52
Dwivedi, Jyoti: 3-11; 11-21
Dwivedi, Rashmi: 2.12; 3-14; 6-18
Dwivedi, S: 4-13; 14-18
Edathil Vijayan, IL-17
Ekka, B.R: 9-8
Ezhilarasan, K: 8-4; 11-9
Farid, M: 12-25
Gaikwad, S B: 9-13; 11-1; 14-9;
Gajendra, O: 1.24
Gambhir, J.K: 14-15
Gandhe, Mahendra, B: 8-18
Gandhi, Kavitha: 3.9
Ganesan, Nalini: 6-25; 7-1; IL-16
Ganesan, Nalini: 8-23; 8-24
Ganesan, T.S: O-4
Ganguly, Anirban: 6-22
Ganguly, Karabi: 1.4
Gathwala, Geeta: 6-10
Gaur, Ranjita, V: 5-11; 13-9
Gayathri, B: 3.1 ; 5-24
Geetha A, 9-19
Geethanjali, F.S: 9-20
Gelal, B: 14-25
George, Jitty: 4-17
Geraghty, Dominic, P: 14-14
Ghosh, A: 9-5; 11-14
Ghosh, Rajeshwary: 5-10
Ghosh, S: 6-9
Ghosh, Sujata: 2.19
Gilsa, E: 4-17
Giri, Satyajeet: 7-10; 11-22
Girish, G.V: 1.4
Goel, Manjusa: 2.5
Golandanz, Smita: 6-6
Gopinath, M: 3.19
Goud, B: 5-18; 6-7; 6-8
Gowda, Shivaraj: 6-24; 8-21; 10-17
Gowda, Shivraj:7-12;7-14;7-18;12-4
Goyal, M.M: 6-30; 6-31
Goyal, S: 13-15
Gujar, K.N: 14-1; 14-2; 14-3
Gulani, Perminder: 4-9
Guleria, Randeep: 10-18
Gupta, B.K: 8-5
Gupta, Bharat Kumar: 11-15
Gupta, Raj Narayan: 10-23
Gupta, Ruby: 5-13; 6-6; 6-21
Gupta, S: 8-25; 8-28
Gupta.,P. R: 4-21
Gurtoo, Anil: 4-12
Habeebullah, S: 13-1
Hadi, S.M: 14-16
Halberg, F: 11-23
Halder, Sanchari: 6-22
Halyal, S.S:11-18
Hamilton, Marc, T: 4-9
Hanif, Sarmad: 14-16
Haque, S.S: 8-16
Haridas, N: 1.7; 1-16; 5-1; 6-9
Hariharasudan, R: 1.25
Harinath, B.C: 8-13; IL-34
Hariprasad, B.N: 2.32
Hartley, T.F: 6-20; IL-10
Hasan, Mahdi: 14-19
Hasan, Sana: 7-8
Hegde, A: 5-25; 10-26
Hen, Gibb, K: 6-20
Herbert, Nicole: 6-20
Herszfeld, Daniella: IL-25
Hitchens, B: 6-20
Holkar S.R: 11-1
Hull, Vinayak: 6-24;7-12;7-14; 7-18
Hundekari, Indira, A: 2.21; 2.22
Ibrahim, Mohammad: 6-13
Ibrahim. Geeta: 14-10
Ilakal. M.B: 10-17
Ilkal, Mahantesh: 6-24; 7-12; 7-14
Ilkal, Mahantesh: 7-18, 8-21
Indo, Hiroko, P: IL-19
Iqbal, Khalid: 12-24
Islam, Ikramul, Maj.: 6-13
Ismail, S.M: 6-8
Iwashita, Yoichiro: IL-19
Iype, Merin, C: 12-5
Jacob, Jose: 2.7
Jacob, Lincy: 2.10
Jacob, Rachel: 3.16
Jacob, Rosemol, M: 10-7
Jadhav, Suvarna, T: 10-11
Jagathlal, P.C: 7-23
Jagtap, P.E: 2.27
Jagtap, Kiran: 11-1
Jagtap, P.E: 2.28; 8-31
Jailkhani, Bansi, L: 8-7
Jailkhani, Rama: 2.22
Jain, Anju: 8-6
Jain, D: 8-25
Jain, Sunesh, K: IL-21
Jakanattane, 4-3
Jakanattane, Rajagovindan, D: 9-7
Jalakandan, B: 11-9
Janet: 10-5
Jap, Tjin-Shing: IL-15
Jasani, Bonny, B: 3.5
Jayachandran, K.S: 11-19
Jayakumar, N: 1.22
Jayanti, E: 4-1
Jayapal, V : 8-11
Jayashree, T: 7-3
Jayasomu, R.S: IL-57
Jayavardhanan, K.K: 11-11; 13-13
Jena, Itishri: 10-3
Jerry, Anitha: 14-22
Jhajharia, Sumit: 8-10
Jialal, Ishwarlar: IL-32
Job, Victoria: 10-14
Joglekar, C: 2.3
John, George, T: 10-14
Jose, A: 10-26
Jose, Cynthia: 11-11
Joseph, P.K: 2.24; 13-10; 14-5; 14-6
Jothimalar: 4-18
Joy, Subin: 2.15
Kadi, Sumangala: 12-4
Kagwad, Vijayetha, S: 8-21; 10-17
Kalaiselvi, V.S: 10-12
Kale K.U: 14-13
Kale, R.K: 10-4
Kalpanadevi, N: 2.31
Kalra, Jaswinder: 2.19
Kamath, Asha: 10-7
Kamath, Sangita: 5-3
Kamath, Saritha, U : 1.13
Kamath, Shobha, U: 12-3
Kamath, Sumana: 12-6
Kamble, P.S:7-4;7-19
Kamble,P.S:12-9; 12-10;12-16
Kanagasabapathy, A.S:9-20
Kaneko, Tsuyoshi: IL-19
Kankra, M: 6-11; 6-26
Kantharaj, N: 6-3
Kanthimathi, M.S: IL-4
Kanugo, K.S: 14-2
Kapoor, Neelkamal: 7-8
Kare, Pawan: 12-12
Karmakar, Partha: 3.19
Karthikesan, K: 14-11
Kaur, J: 8-2; 8-9
Kaur, Navpreet: 13-11
Kaur, Satinder: 13-15
Kaur, Satomder: 13-11
Kaushik, G.G: 5-21
Kaveeshwar, V: 10-26
Kavitha, G: 11-3
Kavitha, S: 4-15
Kavya, R: 4-20; 5-8; 10-10
Ketan, Chorge: 14-13
Khan, Gausal, A: 5-14
Khan, M.Y: 2.11
Khan, S: 6-12
Khan, Zaheed: 3.17
Khandeparkar, Jagdish: 12-24
Khanna, Ashok, Kumar: 14-20
Khanna, Ashwani: 8-6
Khanwelkar, C.C: 10-11
Kharade, S.R: 12-16
Kharb, S: 1.3; 7-5
Kharb, Sandeep, S: 7-9
Khera, Alka: 2.19
Khetrapal, C.L: 14-19
Kiran: 6-9
Kodama, Takuro: IL-19
Kodliwadmath, M.V: 11-16; 12-23
Kodliwadmath, Sheela, M: 12-23
Koner, B.C: 3.8
Kottathveetil, Praveen: 2.24
Krishn, Shiv Ram: 7-11
Krishna, Muralidhara: 6-14; 9-6
Krishna, Shiva, G: 4-1
Krishnakumar, R: 1.10
Krishnamohan, 10-15
Krishnamurthy, N: 3.12
Krishnan, Sajitha: 7-22; 8-29
Krishnananda: 6-17
Krishnaprasad G.N: 9-21
Kulkarni, Rashmi, A: 8-22
Kulkarni, Shruti: 6-24; 7-12;
Kulkarni, Shruti: 7-14; 7-18
Kumar, Alok: 11-4
Kumar, Anil: M: 8-14
Kumar, Arun: 2.31
Kumar, Ashok: 8-16
Kumar, Kiran, B: 6-25
Kumar, Naveen, B: 2.33
Kumar, Phani A: 3.17
Kumar, Pradeep: 2.11; 10-4
Kumar, Ramesh: 2.9
Kumar, Samson Sujit G: 9-1
Kumar, Sathish, P: 2.32
Kumar, Subodh: 8-22
Kumar, Sunil: 2.16
Kumar, Uday: 3-26; 8-16
Kumar, Vijay, B: 13-14
Kumar, Vinay, C: 2.32
Kumar, Vinoth, R: 8-8; 13-6; 13-7
Kumar, Vishnu: 14-20
Kumarchandra, Reshma: 10-25
Kumari, Alka: 2.31
Kumari, Manasa, N:12-8
Kumari, Suchetha, N: 11-13
Kundu, Z.S: 1.3; 7-9
Kuriakose, M.A: 1.27
Kuruvilla, Korah, P: 9-2; 9-3
Laitinen, Päivi: IL-39
Lakshmi, A: 6-29
Lakshmy, R: 10-21
Lal, A.K: 2.26; 3-23
Lal, H: 7-9
Lal, Harbans: 1.3
Lalitha, D.L: 3.6; 8-14
Lalitha, R: 1.1
Lamsal, M: 14-25
Lateef , Abdul: 5-5
Latha, P.G: IL-42
Licy, C.D:1-13; 3.2
Litwak, Sara: IL-25
Lodh, Moushumi: 5-7
Londhe, V.B: 2.27; 2-28; 8-31
Lopez, N: IL-46
López-Hoyos, Marcos: IL-35
Madaan, Himanshu: 6-10; 14-21
Madan, Kaushal: 8-1
Madhale,Sevarina:2.27; 2-28; 8-31
Madhikarmi, Nirjala, Laxmi: 12-7
Madrasi, Narayan, A: 6-32
Magnus, J: 10-8
Mahadevappa, K.L: 9-6
Mahammad, Sadik, A: 7-3
Mahdi, A.A: 2.11; 14-8
Mahdi, Abbas, Ali: 9-17; 11-5;
Mahdi, Abbas, Ali: 14-19; IL-5
Mahdi, Farzana: 9-17; 12-26;
Mahdi, Farzana: 14-8;14-20;
Mahesh, K: 1.10
Mahesh, S: 7-16; 10-1; 12-1
Mahima, B.S: 12-3
Maji, Uttam, K: 5-19
Majima, Hideyuki, J:
IL-19
Makhija, S.J: 8-19
Malathi, M: 5-3; 6-19
Malathi, R: 12-25
Malati, T: IL-44; IL-45
Malik, Rimshida: 12-22
Mallika, B.Siva: 6-7; 6-8
Mallikarjuna, M: 2.23; 3.22
Mammen, Sweetha Mary: 1.14
Mammi, Imbichi: 14-29
Mane, A.Y: 5-22; 9-13
Maneesh, M: 14-27
Manga, Shyamala: 2.13
Mani, M.K:
3.19
Manjrekar, A.P: 5-25; 10-26
Manjrekar, Poornima: 9-11; 9-16
Manjunath, S: 12-4
Manjunatha, G.J: 3-25
Manocha, A: 6-11
Manoj, Paliwal: 3.14
Maria, Elsa: 10-7
Martin, H.D: IL-58
Mashru, Manoj, R:4-19
Math, Avinash, A.K: 6-24; 7-12;
Math, Avinash, A.K:7-14; 7-18
Mathew, Cibu: 4-17
Mathialagan, A: 6-29
Matsui, Hirofumi: IL-19
Maudar, K.K: 8-25; 8-26;
Maudar, K.K: 8-27; 8-28
McCallum, R: IL-56
Meenakshi, V: 2.18
Meera, S: 6-3
Meera: 5-6
Mehdi, Ghazala: IL-7
Mehrotra, S: 11-23
Mehrotra, V:
3.23
Mendiratta, D.K: 8-13
Menon, Krishnakumar: 9-21
Menon, Leela, N: 7-21
Menon, Venugopal, P: IL-31
Miniyar, P.B: 8-19
Mishra, A: 14-7
Mishra, Avanish: 8-22
Mishra, P.K: 8-25; 8-26; 8-27;8-28
Mithbawkar, Shilpa, M: 4-19
Miymoto, Motoharu:
IL-19
Modi, Prabhavati: 10-2
Mogarekar, M.R: 4-14
Mohammed, Shaikh: 2.15
Mohan, T.V: 11-3
Mohanty, Shruti: 1.20
Mohapatra, P.C: 5-15
Mohapatra, Prakash, C: 8-10; 10-3
Mokal, Rajashree, A: 4-19
Mongelli, M: IL-46
More, Kavita: 11-24
Morris, H.A: IL-30
Mrudula, E.V: 7-22
Mujawar: 6-32
Mujica, E: IL-46
Mukherjee, Papia: 6-22
Mukherjee, Sukhes: 14-26; 14-27
Mukherjee, sukhes: 14-28; IL-18
Mukhopadhyay, Ashok K: 8-7
Mukkadan, J.K: 2-24; 13-10;
Mukkadan, J.K: 14-5; 14-6
Multani, J.S: 13-15
Mungli Prakash: 10-10
Munirajan, A.K: 8-4
Munujos, Petraki: IL-36
Murthy, BVLN: 3-10; 5-18
Murthy, Jayaprakash: 4-10; 11-18;
Murthy, Jayaprakash: 9-18; 12-15
Murthy, Rudraiah Siddalinga: 12-7
Murthy, Sreenivasa, M.D: 9-18
Nadarajan, Ghaitri: IL-4
Nagababu, P: 12-25
Nagabhushan, Savitha: IL-46
Nagano, Yumiko:IL-19
Nagarajan, B:
IL-22
Nagendra, D.R: 9-10; 10-22
Naidu, J.N: 9-10; 10-22
Naidu, Shanthi, K: 3.10; 3-17; 5-18
Naidu, Shanthi, K: 6-1; 6-7; 6-8
Naik, Pradeep: 2-23; 3.22;
Naik, Pradeep: 10-20; 13-14
Naik, S.S: 2.3
Nair, Bipin: IL-43
Nair, Madhavan, K: 2.17
Nair, Shalini: 12-24
Nair, Shanthi Kumar:
O-2
Nalini, K: 3.2; 7-16; 13-3
Nampoothiri, Sheela: 1.10
Nancy, Nirmala, K: 8-32; 8-33
Nanda, Smiti: 7-5
Nandeesha, H: 9-14
Nandhu, M.S: 9-2; 9-3
Nandini, C: 7-21
Nandini, D: 11-12
Nandini, M: 12-6
Naqvi, Shoa, IL-7
Narang, A.P.S: 13-11; 13-15
Narayanan, M.P: 1.12; 1-21; 1-24
Narayanasamy, K: 8-1
Narayani: 7-24
Nasir, Tareak-Al: 6-13
Nath, Chandan: 1.8; 11-10; 12-13
Nayak, Gayathry: 11-4
Nayak, Maulik: 1.18;7-2; 7-17;
Nazmi, A: 13-16
Neela, B.M: 3.7
Nehal, M.: 4-5
Nepal, A: 14-25
Neupane, Youb, Raj: 10-19
Nigam, Prashant: 11-7; 12-14
Niranjan, G: 3.8
Nisarga, R: 9-6
Noguchi, Kazuyuki: IL-19
Oellerich, M: KN-2
Ohshima, Mitsuhiro:
IL-19
Ojha, Ramkrishnan: 11-5
Ola, R.P: 2.25; 8-2; 8-9
Omar, Syed: 6-1
Oza, K.J: 14-2
Ozawa, Toshihiko:
IL-19
Padalkar, R.K:7-4; 7-19;12-9
Padalkar,R.K:12-10;12-16
Pahwa, Manju Bala:7-6
Pai, Priya:6-5;6-23;12-22
Pakhale, Mahendra, R: 1.6
Pal, Parthasarathi: 8-30
Palandurkar, K: 6-31
Paliwal, Prachi: 3.14
Pallavi, Uma: 10-7
Pallinti, Vasanthi: 8-23
Pandey, Girish: 14-26
Pandey, R.M.:6-6
Pandey, Ratna: 1.17
Pandey, S: 11-23
Pandey, Shivani: 14-20
Pandhare, V.R:7-4; 7-19;12-9
Pandhare,V.R:12-10;12-16
Pandhi, P:2.25
Paneri, Sangeeta: 2-29; 14-7
Parameswaran: IL-14; IL-52;IL-56
Parchwani, H: 5-21
Parekh, Alok: 1.18; 7-2; 7-17
Pari, L: 14-11
Parida, Ashok: 5-7
Parmar, P.S: 14-3
Parshad, Rajinder: 6-6
Patel, C.S: 14-1
Patel, Jayendra, B: 1-17; 11-25
Patel, Kinjal, R: 11-25
Patel, Prabhudas, S: 1-7; 11-25
Patel, Shruti, R: 11-25
Pathak, A.K: 11-5
Pathak, N: 8-25
Patil, A.J: 2.22
Patil, Anuradha, B: 7-13
Patil, J.A: 2.22
Patil, Sadanand, B: 12-23
Patil, Vijaya: 10-15
Patil, Vinayak, W: 6-32
Patra, Surajeetkumar: 8-6
Pattar, Suhas: 10-9
Paturu Kondaiah, I: L-20
Paul, B.N: 14-8
Paul, Jes: 9-2; 9-3
Paulev, P.E: IL-47
Paulev, Poul-Erik: IL-48
Paulose, C.S: 1-11; 9-2; 9-3
Pawar, Smita B: 2.14
Payne, Natalie: IL-25
Peter, Amalmol: 1.23
Phadke, Madhavi, S: 12-24
Phadke, Varsha D: 3.5
Phani, M.N: 4-20; 5-8; 10-10
Phapale, Yogita, S: 3.18
Pillay, V.V: 2.15
Polavarapu, R: 12-25
Pote, Kiran: 8-18
Potey, G G: 9-13
Powell, S: IL-52
Prabhakar Rao, B: 2.13
Prabhakaran, D: 5-13;6-6; 6-21
Prabhu, Bhavya, K: 6-5; 6-23
Prabhu, K, 6-5;6-23;12-22
Prabhu, Ravindra: 3.2
Pradhan, Ramesh: 8-22
Pradhan, Rosy, L: 8-22
Prajapati, Deepa: 14-19
Prakash, A: 2.26
Prakash, Mungli: 4-20; 5-8;
Prakash, Mungli: 10-1; 12-1
Prasad, Anushre: 13-5
Prasad, C.N: 14-23
Prasad, C.V.B: 11-16
Prasad, K.R: 4-5
Prasad, Shyam, B.R: 9-15
Prashant, 13-16
Pratap, Suryadeep: 3.10; 3-17; 5-18
Prathima, D: 2.2; 6-16
Praveen, K V: 13-10; 14-5; 14-6
Preethi, B.P: 12-15
Preeti Mangala, Preeti: 2.30
Priyadarshini: 3.15
Pullaiah, A: 11-2
Punde, R.P: 8-26; 8-27; 8-28
Punjal, Ravinder: 2.17
Puri, D: 4-13
Quraishi, Rizwana: 8.7
Rabella, Pradeep: 10-8
Radhika, G: 10-8
Rafi, Afshan: 5-5
Raghavendra, B: 5-18; 6-7; 6-8
Raghunandan, Chitra: 11-6
Raghuram, G.V: 8-27
Raghuveer, C.V: 5-25; 9-11
Raizada, A: 2-24; 4-6; IL-26
Rajagovindan, D: 4-3
Rajalekshmy, K.R: 8-32; 8-33
Rajamanickam, G.V: 11-19
Rajasekhar, G: 8-23; 8-24
Rajendran, S.M: 4-8
Rajesh, S: 4-8
Rajkumar, T: 8-32; 8-33
Rajni, S:11-18
Raju, D.S.S.K: 3-6;8-14
Raju KVN: 4-1;8-17;12-8
Raju Venkataramana:10-14
Rajyalakshmi, M: 6-17
Ramachandran, K: 4-22
Ramadevi, K: 8-3
Ramakrishna, 9-1
Ramakrishnan, Lakshmy: 5-13; 8-7
Ramakrishnan, Lakshmy: 6-6; 6-21
Ramakrishnan, T: 12-21
Ramalingam, K: 8-8; 13-6; 13-7
Ramalingam, K: 9-1;9-10; 10-22
Ramana, D: 6-7; 6-8
Ramani, G: 11-3
Ramesh, D: 6-7; 6-8
Ramitha, K: 11-13
Rana, S.V: 2.25; 8-2; 8-9
Rani, Sudha: 9-4; 13-4
Ranjan, Anuj: 2.31
Ranjani, P: 10-16
Ranjeetha, N: 12-25
Rao, A.V: 12-18
Rao, Anjali: 1-13; 6-5; 6-23
Rao, Anjali: 6-17; 10-7; 11-4; 12-22
Rao, Gayatri, M: 12-19; 12-20
Rao, Madhusudhana, A: 3.1
Rao, Nivedita, L: 2.7
Rao, Prabhakar, B: 14-23
Rao, Pragna: 5-5; IL-53
Rao, Radhakrishna: 13-12
Rao, Rama, J: 10-2
Rao, Ramchandra, O: 7-3
Rao,