[Show abstract][Hide abstract] ABSTRACT: Vitamin D deficiency is reported to be involved in pathogenesis of ovarian cancer. But the mechanism is yet to be explored. An imbalance between Th1 and Th2 activity play a crucial role in pathogenesis of many cancers. The purpose of the study is to find out the Th1/Th2 status by estimating TNF-α (Th1 marker) and IL-4 (Th2 marker) in ovarian cancer cases and controls and to correlate these with serum vitamin D levels.
A case-control study with 50 ovarian cancer cases and 50 healthy controls was conducted. The cytokines TNF-α and IL-4 were estimated by ELISA. Serum vitamin D was measured by electro-chemiluminescence immunoassay method.
Median TNF-α levels (12.2 vs 6.2 pg/ml; p value <0.001) were significantly higher in ovarian cancer patients and mean IL-4 levels (2.22 ± 0.51 vs 2.99 ± 0.68 pg/ml; p value <0.05) were significantly lower as compared to those of controls. Levels of TNF-α and IL-4 did not vary significantly with clinical staging, and histological grading. Vitamin D levels were negatively correlated with TNF-α and positively correlated with IL-4.
Low vitamin D levels promotes Th1 activity increasing TNF-α levels and inhibits Th2 activity decreasing IL-4 levels in ovarian cancer. These low levels of vitamin D may induce pro-inflammatory micro ambience which might contribute to pathogenesis of ovarian cancer.
Full-text · Article · Mar 2015 · Clinical and Translational Oncology
[Show abstract][Hide abstract] ABSTRACT: Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine at 48-72h after diagnostic or interventional coronary angiography. It is too late for an early intervention. Neutrophil gelatinase associated lipocalin (NGAL) and cystatin C are novel markers of AKI. We determined the optimum cut off level of NGAL and cystatin C in early diagnosis and prediction of AKI in patients undergoing coronary angiography followed by angioplasty.
In a nested case control study, serum NGAL, cystatin C by ELISA and serum creatinine by Jaffe's kinetic method were estimated at 0, 4, 24 and 48h of coronary angiography followed by angioplasty in 30 cases who developed contrast-induced AKI and 30 subjects who did not develop AKI. eGFR was estimated for both cases and controls by the MDRD equation. ROC was used to determine optimum cut-off.
Serum NGAL increased sharply at 4h after the procedure and then gradually declined to near normal level at 48h in AKI cases. The rise in cystatin C peaked at 24h and then declined but remained high till 48h. In controls, they remained static. Optimum cut-off of serum NGAL and cystatin C was 155.2ng/ml and 0.517mg/l respectively at 4h and 89.5ng/ml and 0.99mg/l respectively at 24h of angiography. Odds ratio for hypertensives to develop AKI was 3.57 (CI: 1.2-11.1, P=0.03).
Serum NGAL and cystatin C may act as early markers of contrast-induced AKI in patients undergoing percutaneous coronary intervention. Patients with hypertension are susceptible to develop contrast-induced AKI.
No preview · Article · May 2014 · Clinica chimica acta; international journal of clinical chemistry
[Show abstract][Hide abstract] ABSTRACT: The present study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed as per WHO guideline. Nineteen (27%) of them had HADS anxiety and depression score ≥8 (abnormal HADS score). The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS, but LH and FSH correlated positively. There was no change in GnRH with the change in stress or testosterone levels. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Sperm count correlated positively with total testosterone and negatively with FSH and LH. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. Psychological stress primarily lowers serum total testosterone level with secondary rise in serum LH and FSH levels altering seminal quality. Stress management is warranted for male infertility cases.
[Show abstract][Hide abstract] ABSTRACT: Background
Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine at 48–72 h after diagnostic or interventional coronary angiography. It is too late for an early intervention. Neutrophil gelatinase associated lipocalin (NGAL) and cystatin C are novel markers of AKI. We determined the optimum cut-off level of NGAL and cystatin C in early diagnosis and prediction of AKI in patients undergoing coronary angiography followed by angioplasty.
In a nested case control study, serum NGAL, cystatin C by ELISA and serum creatinine by Jaffe's kinetic method were estimated at 0, 4, 24 and 48 h of coronary angiography followed by angioplasty in 30 cases who developed contrast-induced AKI and 30 subjects who did not develop AKI. eGFR was estimated for both cases and controls by the MDRD equation. ROC was used to determine the optimum cut-off.
Serum NGAL increased sharply at 4 h after the procedure and then gradually declined to near normal level at 48 h in AKI cases. The rise in cystatin C peaked at 24 h and then declined but remained high till 48 h. In controls, they remained static. The optimum cut-off of serum NGAL and cystatin C was 155.2 ng/ml and 0.517 mg/l respectively at 4 h and 89.5 ng/ml and 0.99 mg/l respectively at 24 h of angiography. Odds ratio for hypertensives to develop AKI was 3.57 (CI: 1.2–11.1, p = 0.03).
Serum NGAL and cystatin C may act as early markers of contrast-induced AKI in patients undergoing percutaneous coronary intervention. Patients with hypertension are susceptible to develop contrast-induced AKI.
[Show abstract][Hide abstract] ABSTRACT: Objective:
To study the renal function in term newborns with perinatal asphyxia including urinary excretion of β2 microglobulin (β2M).
This case control study included 50 term newborn babies with perinatal asphyxia and 50 normal babies as matched controls. In all cases, asphyxia grading (using Apgar score) and Hypoxic ischemic encephalopathy (HIE) staging (Sarnat and Sarnat) were done. Blood and urinary parameters (including β2M) for renal function were done in all and Fractional excretion of sodium (FENa) and Renal failure index (RFI) were calculated. The renal parameters were compared within subgroups as well as controls using analysis of variance test and the independent samples t test.
Acute kidney Injury (AKI) was noted in 56 % of cases (24 % prerenal and 32 % intrinsic type). All 9 babies who died had AKI. Serum parameters like urea, creatinine, sodium and potassium had better correlation with the renal function as compared to urine parameters. All individual urine parameters except β2M showed wide variations. FENa, RFI and urinary β2M increased with increasing severity of asphyxia and HIE staging.
AKI is common in term babies with perinatal asphyxia. FENa and RFI are useful parameters for assessing the renal function and urinary β2M is a good biomarker for diagnosis and prognosis of acute tubular injury in term babies with perinatal asphyxia.
No preview · Article · Jun 2013 · The Indian Journal of Pediatrics
[Show abstract][Hide abstract] ABSTRACT: INTRODUCTION: Vitamin D deficiency and vitamin D receptor (VDR) gene polymorphism, FokI, is reported to increase the risk of many cancers. Role of vitamin D and its receptor polymorphisms in ovarian cancer has not been clearly defined. OBJECTIVE: To study the levels of serum vitamin D and occurrence of vitamin D receptor gene polymorphism (FokI) in cases of ovarian cancer. MATERIAL AND METHODS: FokI genotyping was done by PCR-RFLP technique and vitamin D levels were estimated by chemiluminescence immunoassay. RESULTS: Serum vitamin D levels were significantly (p < 0.03) lower in ovarian cancer cases as compared to controls. The homozygous (TT) and heterozygous (CT) genotype predispose to the development of ovarian cancer in Indian population (OR: 2.37, 95% CI: 1.04-5.44) as compared to the homozygous (CC) genotype. Vitamin D deficiency and VDR gene polymorphism (FokI) act non-synergistically (p value < 0.4). CONCLUSION: Low blood levels of vitamin D and VDR receptor polymorphism (FokI) might be a risk factor for the development of ovarian cancer. Other novel ligands of vitamin D receptor might be responsible for the non-synergistic effect.
Full-text · Article · May 2013 · Journal of Ovarian Research
[Show abstract][Hide abstract] ABSTRACT: Objectives: This study was conducted to know the status of thyroid disorder in people of far western region of Nepal.
Methods: A total of 808 cases, out of which 133 male and 675 female were included and study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Nepalgunj Teaching Hospital, Kohalpur, Banke, Nepal, between 1st January, 2011 and 28th February, 2012. The variables collected were age, sex, and thyroid function profile including free T3, free T4 and TSH. The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version.
Results: The percentage of thyroid disorders was 33.66% in people of far western region of Nepal. The people were highly affected by overt hyperthyroidism (14.9%) followed by subclinical hyperthyroidism (9.9%). The subclinical hypothyroidism was 7.9% while 1% overt hypothyroidism only. Serum fT3, fT4 and TSH level were significantly different in male and females. Similarly, fT3, fT4 and TSH levels show statistically significant differences in different thyroid disorders. The fT3 and fT4 level in overt hyperthyroidism and subclinical hypothyroidism showed statistically significant differences when compared with euthyroidism group. Likewise, TSH level also shows statistically significant in all the thyroid disorders when compared with euthyroidism group. The fT3 and fT4 levels were statistically insignificant in all the age groups whereas TSH level showed statistically significant different in all the age groups. The fT3 and fT4 level in 21-40 years showed statistically significant when compared with serum level of fT3 and fT4 of 0-20 years. Similarly, serum level of TSH in 21-40 and 41-60 years also showed statistically significant when compared with serum level of TSH of 0-20 years.
Conclusion: The people residing in far western region have risk for thyroid disorders. They were suffering with thyroid disorder, especially overt hyperthyroidism (14.9%) and subclinical hyperthyroidism (9.9%). Further studies are required to characterize the reasons for this high prevalence of overt hyperthyroidism and subclinical hyperthyroidism.
Key words: Free T3, Free T4, TSH, Hyperthyroidism, Hypothyroidism, Nepal
Full-text · Article · Oct 2012 · Bangladesh Journal of Medical Science
[Show abstract][Hide abstract] ABSTRACT: Abstract
Objective: The study was conducted to assess biochemical profiles in premenopausal and postmenopausal
women having breast cancer. Materials and Methods: A hospital based case control study was carried out
at Manipal Teaching Hospital (MTH), Pokhara, Nepal. The analysed variables were age, metabolic profile
including total cholesterol, triglycerides, HDL-C, LDL-C, blood sugar, insulin concentration, C-peptide, HbA1c
and selenium. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and
SPSS 16 software. Results: In premenopausal women, significant differences were noted for total cholesterol (P value <0.001), triglycerides (P value 0.002), HbA1c level (P value <0.001), insulin concentration (P value 0.030), C-peptide concentration (P value 0.001), and selenium (P value <0.001) between cases and controls. Insignificant results were found for HDL-C (P value 0.749), LDL-C (P value 0.933), blood sugar (P value 0.59) and BMI (P value 0.746). Similarly, significant difference in total cholesterol (P value <0.001), triglycerides (P value 0.001), LDL-C (P value <0.001), HDL-C (P value 0.025), blood sugar (P value <0.001), insulin concentration (P value <0.001), c-peptide concentration (P value <0.001), HbA1c level (P value <0.001) and selenium (P value <0.001) were observed for postmenopausal patients and controls. Conclusions: Assessing metabolic changes and their management may be important for control of breast cancer and increased survival. Keywords: Breast cancer - premenopausal - postmenopausal - Nepal
Full-text · Article · Jul 2012 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: Total and differential leucocyte count (TLC and DLC) in blood circulation influence humoral immune response and stress alters TLC and DLC by leucocyte misdistribution. Chlordiazepoxide, a widely used benzodiazepine anti-stress agent, is reported to reverse suppression of antibody response induced by acute stress but not by chronic stress. The effect of chlordiazepoxide on the changes in leucocyte count by acute and chronic stress has not been clearly defined. We examined the effect of restraint stress (1 h/day) for 6, 10, 14 and 21 days on TLC and DLC and their modulation by chlordiazepoxide pretreatment (10 mg/kg/day) 1 h before exposure to stress in albino rats. Acute stress, i.e. restraint stress (1 h/day) for 6 and 10 days with or with out chlordiazepoxide pretreatment did not alter TLC and DLC. Chronic stress, i.e. restraint stress (1 h/day) for 14 and 21 days significantly decreased TLC and the percentage of lymphocytes in comparison to control. Pretreatment with chlordiazepoxide reversed these changes. We conclude that chlordiazepoxide, a benzodiazepine, reverses changes in TLC and DLC probably by improving chronic stress-induced leucocytes misdistribution.
No preview · Article · Jan 2012 · Immunopharmacology and Immunotoxicology
[Show abstract][Hide abstract] ABSTRACT: Lipoprotein (a) and homocysteine are two important independent risk factors for coronary atherosclerosis. Lipoprotein (a) is a low-density lipoprotein -like particle formed by the association of the highly polymorphic glycosylated apolipoprotein (a) with apolipoprotein-B100. Homocysteine is formed as a by-product of the metabolism of amino acid methionine. The present review attempts to elaborate the roles of homocysteine and lipoprotein (a) in the etiopathogenesis of CAD and the inter relationship between these two established risk factors. The literature was searched from the websites of the National Library of Medicine (http://www.ncbi.nlm.nih.gov/) and Pub Med Central, the U.S. National Library of Medicine's digital archive of life sciences journal literature. The role of homocysteine and lipo-protein (a) has been extensively investigated during the past few decades. The outcomes have been varied with both favourable and unfavourable inferences. Certain researchers have also pointed towards interplay between these two risk factors at the molecular level. A better understanding of the interaction between the risk factors of CAD will help in better risk stratification and management of this disease.
No preview · Article · Oct 2011 · Biomedical Research
[Show abstract][Hide abstract] ABSTRACT: Pregnancy-induced hypertension (PIH) is associated with oxidative stress and low plasma proteins. This study explored the effect of oxidative stress on plasma protein level in PIH.
Serum total proteins (TP), albumin, globulin, malondialdehyde, protein carbonyls (PC) and protein bound sialic acid (PBSA) were measured in gestational hypertensive, pre-eclamptic, eclamptic and healthy pregnant women (n=20/group). Serum proteins were separated by electrophoresis for assessing protein damage.
Serum TP and albumin decreased and malondialdehyde, PC & PBSA increased significantly in all PIH subgroups as compared to healthy pregnant subjects. Serum globulin levels decreased only in eclampsia. Malondialdehyde and PC negatively correlated with albumin level. Protein fragmentation and aggregation in eclampsia were evident from electrophoretogram.
We conclude that oxidative damages to proteins contribute to decreased serum protein levels in PIH and hypersialylation of plasma proteins is probably body’s protective mechanism to combat oxidative protein damage in PIH.
[Show abstract][Hide abstract] ABSTRACT: Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, have been reported as putative tumor markers because of their involvement in cancer invasion and metastasis. The aim of our study was to elucidate the possible role of MMP-2 and -9 as serum prognostic biomarker for breast cancer classification and correlate it with the clinicopathological variables.
Our study consisted of 60 females with primary breast cancer, 40 cases of benign breast disease and 60 healthy female volunteers as controls. The serum MMP-2 and -9 levels were quantitatively measured by ELISA technique.
A significantly raised MMP-2 and MMP-9 levels were observed in breast cancer patients. Significant rise in serum MMP-9 concentration was found in patients presenting with metastasis as well as in those cases who presented with a duration of less than 1year. ROC analyses depicted a serum cutoff value of 315ng/mL for MMP-9 to discriminate the breast cancer patients from the control group.
Our results suggest that serum MMP-9 level is a better marker than serum MMP-2 in predicting the breast cancer development and progression.
No preview · Article · Jul 2011 · Clinical biochemistry
[Show abstract][Hide abstract] ABSTRACT: Lead poisoning is most commonly caused by occupational exposure. It presents with a myriad of signs and symptoms ranging from mild anemia to frank encephalopathy, depending on the blood lead levels as well as the duration of exposure. Intake of herbal/Ayurvedic medicine may also lead to plumbism as heavy metals are often incorporated in such medications with the belief that such metals have medicinal properties.
We report a case of lead poisoning caused by Ayurvedic medication. The patient presented with symptoms of intestinal obstruction to the surgical casualty.
The patient presented with symptoms that mimicked intestinal obstruction. No specific etiology could be determined. Serum lead levels were determined and diagnosis of lead poisoning ascertained. The lead content of the medicine was analyzed and it contained 30% w/w lead.
The diagnosis of heavy metal poisoning consequent to intake of alternative medicine must be kept in mind when a patient presents with vague complaints.
Full-text · Article · Oct 2010 · Clinica chimica acta; international journal of clinical chemistry
[Show abstract][Hide abstract] ABSTRACT: To study the serum levels of oxidative stress markers - malondialdehyde (MDA) and protein carbonyl in babies with perinatal asphyxia and to correlate their levels with the outcome in terms of mortality and neurodevelopmental sequelae.
A group of 40 term AGA (appropriate for gestational age) infants with perinatal asphyxia were selected as cases and same number of healthy babies as controls. Serum levels of oxidative stress markers - malondialdehyde and protein carbonyl were determined in cord blood and at 48 hours of life. Their levels were correlated with the outcome of perinatal asphyxia in terms of mortality and the long term neurological outcome.
MDA and protein carbonyl, in cord blood were significantly higher among cases (5.88+/-1.40 micromol/L and 1.50+/-0.48 nmol/mg of protein respectively) than controls (3.11+/-0.82 micromol/L and 0.83+/-0.19 nmol/mg of protein respectively). Among the cases, MDA and protein carbonyl values at 48 hours of life (7.52 +/- 1.06 micrommol/L and 2.91 +/- 0.62 nmol/mg of protein respectively) were significantly higher than those at birth. MDA at birth and 48 hours was significantly higher among babies who had seizures than those who remained seizure free. These values were also significantly higher in babies who expired as compared to those who survived. Protein carbonyl values though higher in those who had seizures and in those who expired, were not statistically significant from controls. MDA and protein carbonyl at birth and 48 hours were higher in babies with developmental delay but the association was not statistically significant.
In hypoxic ischemic encephalopathy (HIE), oxidative stress markers MDA and protein carbonyl are high at birth and rise further at 48 hours and the values correlate with the morbidity and mortality. Therefore, determining the serum levels of oxidative stress markers MDA and protein carbonyl will be of benefit in predicting the outcome in perinatal asphyxia.
Full-text · Article · May 2010 · The Indian Journal of Pediatrics
[Show abstract][Hide abstract] ABSTRACT: This study was carried out to assess whether the postprandial urinary alkaline tide, as a marker for the completeness of vagotomy, is dependent on the nature of the test meal, whether it is affected by proton pump inhibitor therapy, and whether it is reliable.
The postprandial urinary alkaline tide (PUAT) pattern was prospectively assessed in three different study groups and one control group of healthy volunteers. The three study groups were as follows; A (n = 20) i.e. the Proton Pump Inhibitor (PPI) Group; B (n = 25) i.e. the Truncal Vagotomy (TV) Group; and C (n = 5) i.e. the Recurrent Ulcer (RU) Group. Urinary pH was measured by a pocket digital pH meter.
Postprandial urinary alkaline tide in the control group was significantly higher compared to the fasting levels. Liquid diet did not elicit a significant urinary alkaline tide response. There was a statistically significant fall in both fasting urinary pH (5.34 +/- 0.70 vs. 4.80 +/- 0.61, p = 0.031) and the postprandial alkaline tide (6.99 +/- 0.79 vs. 4.94 +/- 0.63, p = 0.0001) after taking proton pump inhibitors. In the truncal vagotomy and gastrojejunostomy group it was found that there was a significant fall in both the mean fasting (5.28 +/- 0.58, vs. 4.92 +/- 0.66, p = 0.032) and the postprandial urinary pH (6.29 +/- 0.92 vs. 5.09 +/- 0.73, p = 0.0001) following surgery.
This study establishes that simple measurement of the urinary pH before and after a standard test meal can be used as an accurate routine test for the completion of vagotomy. It also showed that proton pump inhibitors abolish the alkaline tide and therefore must be discontinued before measuring the alkaline tide. Liquid test meal was not effective in eliciting an alkaline tide as compared to a solid meal.
Full-text · Article · Jan 2010 · Tropical gastroenterology: official journal of the Digestive Diseases Foundation
[Show abstract][Hide abstract] ABSTRACT: The increased prevalence of upper normal limit of TSH and raised anti-thyroperoxidase antibody titer indicate, relatively more frequent occurrence of compensated thyroid function in infertile women. This finding necessitates considering such cases for a thorough investigation of pituitary-thyroid axis. In addition, as some patients may exhibit the clinical picture of hypothyroidism despite normal TSH and free thyroxin (FT4) concentrations, this hospital-based study was undertaken to review the impact of thyroid status on the menstrual function and fertility of the subjects.
In this study, we investigated 160 women with primary infertility who attended the Biochemistry department, Maulana Azad Medical College (MAMC), New Delhi for hormonal evaluations. Eighty fertile women with similar age and socioeconomic status were enrolled as the controls. The association between thyroid dysfunction and levels of serum prolactin, LH and FSH as their menstrual status were reviewed.
The majority of the infertile and fertile women were euthyroid. In infertile group, the crude prevalence of hypothyroidism was slightly higher in the infertile group in comparison with that of the general population. There was a positive correlation between serum TSH and prolactin levels in the infertile subjects. Menstrual disorders (mainly oligomenorrhea), were reported by about 60% of the infertile women. Hyperprolactinemia was depicted in 41% of the infertile women while it was only 15% in the control group. The infertile women with hypothyroidism had significantly higher prolactin levels when compared to the subjects with hyper- or euthyroidism. There was a significant association between abnormal menstrual patterns and anovulatory cycles, as observed on endometrial examination of infertile subjects with raised serum prolactin levels.
There is a greater propensity for thyroid disorder in infertile women than the fertile ones. There is also a higher prevalence of hyperprolactinemia in infertile patients.
Full-text · Article · Oct 2009 · Journal of Reproduction and Infertility
[Show abstract][Hide abstract] ABSTRACT: Oxidative stress is implicated as a common pathologic mechanism contributing to the initiation and progression of hepatic damage in a variety of liver disorders. Present study attempts to evaluate the hepatoprotective activity of picroliv, curcumin and ellagic acid in comparison to silymarin using paracetamol (PCM) induced acute liver damage. Hepatotoxicity was induced by administering a single oral dose of PCM (500 mg/kg) and was assessed by quantifying the serum enzyme activities, phenobarbitone induced sleeping time and histopathological analysis of liver tissues. The antioxidant parameters, malondialdehyde (MDA), reduced glutathione (GSH) and catalase of the liver tissue were also assessed. The herbal drugs were administered for 7 days by oral route at 50 and 100 mg/kg. PCM induced hepatic damage was manifested by a significant increase in the activities of marker enzymes (alanine transaminase, aspartate transaminase and alkaline phosphatase) in serum and MDA level in liver. There was also a significant decrease in activity of GSH and catalase levels. The histopathological examination on toxic models revealed centrizonal necrosis and fatty changes. Pretreatment of mice with picroliv, curcumin and ellagic acid reversed these altered parameters towards normal values, which were compared with silymarin. The normalization of phenobarbitone induced sleeping time suggests the restoration of liver cytochrome P450 enzymes. This study supports the use of these active phytochemicals against toxic liver injury, which may act by preventing the lipid peroxidation and augmenting the antioxidant defense system or regeneration of hepatocytes. These active phytochemicals may be developed as drugs for the treatment of liver diseases.
Full-text · Article · Aug 2009 · Fundamental and Clinical Pharmacology