Indian Journal of Medical Biochemistry

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2022 | September-December | Volume 26 | Issue 3

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EDITORIAL

Anuupama Suchitta, Binita Goswami

An Intelligence-guiding Future Research

[Year:2022] [Month:September-December] [Volume:26] [Number:3] [Pages:1] [Pages No:iv - iv]

   DOI: 10.5005/ijmb-26-3-iv  |  Open Access | 

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ORIGINAL RESEARCH ARTICLE

Poonam Jain, Anil Kumar Batta, Pashaura Singh

Comparative Study of Serum Levels of Gamma-glutamyl Transferase, Aspartate Aminotransferase (AST), Alanine Transaminase (ALT), AST:ALT, and Bilirubin in Patients with Chronic Hepatitis

[Year:2022] [Month:September-December] [Volume:26] [Number:3] [Pages:4] [Pages No:73 - 76]

Keywords: Alanine transaminase, Aspartate aminotransferase, Bilirubin, Chronic hepatitis, Gamma-glutamyl transferase

   DOI: 10.5005/jp-journals-10054-0208  |  Open Access |  How to cite  | 

Abstract

Introduction: Viral hepatitis and other liver-related diseases are mostly difficult to diagnose solely based on clinical regimes. Liver damage results in alterations in serum enzyme patterns which have been used to develop many enzyme-based assays. Aim and objectives: The major clinical consequences of chronic liver disease can be evaluated by liver function tests like bilirubin, gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine transaminase (ALT). Alanine transaminase and AST changes indicate leakage from damaged hepatocytes. The present study was conducted to compare the serum levels of GGT, AST, ALT, AST:ALT ratio, and bilirubin in patients with chronic hepatitis. Materials and methods: The study group comprised 100 clinically diagnosed patients with chronic hepatitis and 100 controls. Results: Case–control comparison showed statistically higher values of GGT (p < 0.01), AST (p < 0.05), ALT (p < 0.05), AST:ALT (p < 0.01), and bilirubin (p < 0.05) in cases and serum levels of GGT, AST:ALT, and bilirubin were sensitive and specific when various parameters were compared with each other in various hepatitis and controls. Conclusion: The present study indicates that the parameters GGT, AST, ALT, AST:ALT ratio, and bilirubin are associated with increased risk of hepatitis. Clinical significance: The serum levels of GGT, AST, ALT, AST:ALT ratio, and bilirubin can be used for the biochemical profiling of different types of patients with hepatitis.

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ORIGINAL RESEARCH ARTICLE

Indranil Basu, Soma Gupta, Abhishek Mukherjee, Mandeep Bedi, Subhalakshmi Sengupta, Bibekananda Panda

Retrospective Assessment of Antinuclear Antibody by Indirect Immunofluorescence Microscopy and Immunoblot in Patients with Polyarthritis

[Year:2022] [Month:September-December] [Volume:26] [Number:3] [Pages:4] [Pages No:77 - 80]

Keywords: Antinuclear antibody, Immunoblot, Immunofluorescence microscopy, Polyarthritis

   DOI: 10.5005/jp-journals-10054-0209  |  Open Access |  How to cite  | 

Abstract

Introduction: Detection of antinuclear antibody (ANA) by immunofluorescence assay (IFA) is the method of choice for screening autoimmune polyarthritis, where the different patterns are etched in the cellular components as per the group of antibodies present in the patient. Like all other screening tests, it has its sensitivity and specificity, and the final confirmation is done by doing a multispot immunoblot testing, where the specific antibodies against a specific antigen is detected. Aims and objectives: The study aimed at finding out the sensitivity and specificity of IFA with respect to immunoblot assay and to detect whether any pattern can be detected to attribute to false-positive and false-negative cases. Materials and methods: The conducted study is a retrospective analysis of 100 reports available from the Laboratory Information System. Patients referred by rheumatologists with clinical polyarthritis prescribed for both ANA by IFA and immunoblot are taken for the study. Sensitivity and specificity of ANA by IFA is calculated taking immunoblot as confirmatory gold standard. Results: The sensitivity and specificity were calculated as 80 and 84.3%, respectively, in polyarthritis cases and anticell (AC)-1 and AC-4 were implicated in most of the false-positive and false-negative cases. Conclusion: Antinuclear antibody by IFA needs confirmation by immunoblot for antibody profile characterization. AC-1 and AC-4 if detected on IFA mandates for immunoblot as most of the false positives and negatives are implicated with these patterns.

467

ORIGINAL RESEARCH ARTICLE

Assay of Serum Iron and TIBC: A Preliminary Study for Survey Shortlisting Suspected Tuberculosis Patients

[Year:2022] [Month:September-December] [Volume:26] [Number:3] [Pages:6] [Pages No:81 - 86]

Keywords: Carboxymycobactin, Mycobactin, Siderophores, Superoxide dismutase, Transferrin

   DOI: 10.5005/jp-journals-10054-0210  |  Open Access |  How to cite  | 

Abstract

Aim: Mycobacterium tuberculosis (Mtb) growing within the phagosome of macrophases secretes siderophores, a small molecule having a high affinity for Fe+3 iron, to take up iron-loaded mycobactin (MBT) and carboxymycobactin (CMBT) from the environment to meet its iron (Fe) need. Mycobacterium tuberculosis is well capable to utilize Fe from heme and hemoglobin by the secretion of heme-binding protein, cell surface proteins, etc., by the mycobacteria. On the other hand, the measurement of serum total iron binding capacity (TIBC) denoting the maximum amount of Fe carried by transferrin (Tf) present in serum entails indirectly a measure of serum Tf level. The index author has interpreted the serum iron and serum TIBC level and the ratio of serum iron and serum TIBC as a preliminary survey to shortlist the suspected population deserving confirmatory test for tuberculosis (TB). This is to categorically declare that assay of these parameters is not to be used as TB diagnostic but only for shortlisting suspected TB patients from the general population. Materials and methods: The study was conducted on total of 180 participants divided into 3 groups: Group I - normal control (n = 45); Group II - lung disease control (n = 45); and Group III - patients suffering from TB (3A: Pulmonary TB (n = 45) and 3B: Extrapulmonary TB (n = 45)). Serum Fe and TIBC levels were measured for all participants and also for group III and group II subjects after one month with the usual treatment. The level of significance was assessed using Student's t-test. All the subjects in this study had normal liver function tests and they did not suffer from iron overload diseases or any malabsorption of iron syndrome. Result: At baseline, serum Fe was significantly high in TB patients whereas serum TIBC was significantly decreased. After one month's additional anti-TB (A-TB) drug treatment serum iron had increased but not significantly (p = 0.15) and serum TIBC had increased significantly (p = 0.04). Statistical computation of the ratio of serum Fe and serum TIBC in TB patients had shown to be as high as 0.63, and more than that. Conclusion: From statistical computation, it might be conferred that serum Fe more than 149 µg/dL and the ratio of serum Fe to serum TIBC more than 0.63 (which is more important) in preliminary survey detecting TB patients would shortlist the TB suspects deserving confirmatory test for TB diagnosis.

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ORIGINAL RESEARCH ARTICLE

Pawan Kumar, Isha Malik, Sumit Sachdeva

Serum Vitamin D and Uric Acid Levels in Glaucoma Patients: A Comprehensive Investigation

[Year:2022] [Month:September-December] [Volume:26] [Number:3] [Pages:3] [Pages No:87 - 89]

Keywords: Glaucoma, Optic nerve, Radioimmunoassay, Uric acid, Vitamin D

   DOI: 10.5005/jp-journals-10054-0211  |  Open Access |  How to cite  | 

Abstract

Objective: Glaucoma is an eye condition characterized by optic nerve damage due to inflammation and oxidative stress, often associated with increased intraocular pressure (IOP). Vitamin D, a fat-soluble vitamin with anti-inflammatory properties, and uric acid (UA), an antioxidant molecule capable of scavenging nitrogen radicals and superoxide in plasma, were the specific biomarkers of interest in this research. Therefore, the aim of this study was to assess serum levels of vitamin D and UA in glaucoma patients within the North Indian population. Materials and methods: The study enrolled 45 age and sex-matched controls and 45 glaucoma patients. Serum levels of vitamin D and UA were measured using the radioimmunoassay (RIA) and enzymatic methods, respectively. Results: The analysis revealed that the mean of vitamin D in the test group was 23.42 ± 6.56 (ng/mL), while in the control group, it was 29.28 ± 2.58 (ng/mL). Similarly, the UA level was 4.57 ± 1.19 (mg/dL) in the test and 5.87 ± 1.74 in the control. Conclusion: The present research demonstrated that the level was significantly lowered in both vitamin D and UA in glaucoma patients compared to healthy individuals. These findings emphasize the importance of routinely estimating serum vitamin D and UA in individuals suspected of having glaucoma. Additionally, the results may prove valuable for ophthalmologists in managing and monitoring patients with glaucoma.

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CASE REPORT

Parth Balvantbhai Chanv, Simbita Marwah, Sargam Bhatt, Kiran Goplani, Suhani Nayak, Uma Nayak

Overcoming Obstacles: A Case Report of Preterm Neonatal Respiratory Distress Syndrome with Coexisting Hydrocephalus, Aqueductal Stenosis, and Neonatal Hyperbilirubinemia

[Year:2022] [Month:September-December] [Volume:26] [Number:3] [Pages:3] [Pages No:90 - 92]

Keywords: Aquedutcal stenosis, Case report, Hydrocephalus, Neonatal-hyperbilirubinemia, Preterm infant, Respiratory distress syndrome

   DOI: 10.5005/jp-journals-10054-0212  |  Open Access |  How to cite  | 

Abstract

Aim: The aim of present report is to describe the diagnosis and management of a preterm neonate with coexisting respiratory distress syndrome (RDS), hydrocephalus, aqueductal stenosis, and neonatal hyperbilirubinemia (NNH). Background: A 31-day-old preterm male infant with RDS, neonatal hyperbilirubinemia, Intrauterine growth restriction (IUGR), aqueductal stenosis, and hydrocephalus was admitted to the neonatal intensive care unit (NICU) and received oxygen support and double volume exchange transfusion. Physical examination showed yellow skin discoloration, triangular facies, moderate hepatosplenomegaly, and hypertonia. A hematological workup revealed anemia, leukocytosis, Staphylococcus haemolyticus growth, and elevated bilirubin levels. Ultrasonography (USG) brain showed dilated ventricles and aqueduct effacement, leading to the diagnosis of hydrocephalus due to aqueductal stenosis, and a positive toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV (TORCH) test. Case description: A 31-day-old preterm male infant with multiple medical conditions, including RDS, hyperbilirubinemia, IUGR, aqueductal stenosis, and hydrocephalus, was admitted to the NICU for 30 days. The baby showed yellow skin discoloration, triangular facies, moderate liver/spleen enlargement, hypertonia, and anemia. USG brain showed dilated ventricles and aqueduct effacement, leading to a diagnosis of hydrocephalus due to aqueductal stenosis. The baby was also diagnosed with TORCH (Toxoplasma) positive. Conclusion: The present case report highlights the complexity and challenges associated with managing a preterm male infant with multiple medical conditions. The diagnosis of RDS, neonatal hyperbilirubinemia, IUGR, aqueductal stenosis, and hydrocephalus required a comprehensive approach, including oxygen support, double volume exchange transfusion (DVET), and hematological workup. The management of the infant's conditions emphasized the importance of prompt and accurate diagnosis and aggressive treatment strategies. The successful outcome in this case, highlights the potential of multidisciplinary approaches in improving the prognosis of infants with multiple medical conditions and emphasizes the need for continuous monitoring and intervention to ensure optimal outcomes. Clinical significance: Clinical significance refers to the practical importance or real-world impact of the findings or information presented in the case report. It highlights how the case report contributes to the current understanding of a medical condition, its diagnosis, and treatment, and how it can help improve patient care. In a case report, the clinical significance is often summarized in the conclusion and highlights the important takeaways for healthcare professionals.

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