Indian Journal of Medical Biochemistry

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2023 | September-December | Volume 27 | Issue 3

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EDITORIAL

Anju Jain

Adieu from the Editor's Desk

[Year:2023] [Month:September-December] [Volume:27] [Number:3] [Pages:1] [Pages No:iv - iv]

   DOI: 10.5005/ijmb-27-3-iv  |  Open Access | 

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ORIGINAL RESEARCH ARTICLE

Flavia Almeida, Alap Christy, Raj Jatale, Nilam Tripathi, Lynda Rodrigues

Prevalence of Autoantibodies in Type 1 Diabetes Mellitus and the Clinical Utility of Diabetes Antibody Testing in the Indian Population: A Retrospective Study of 3 Years

[Year:2023] [Month:September-December] [Volume:27] [Number:3] [Pages:5] [Pages No:45 - 49]

Keywords: Autoantibodies, Autoimmunity, Anti GAD-65, Islet cell antibody, Type 1 diabetes mellitus

   DOI: 10.5005/jp-journals-10054-0222  |  Open Access |  How to cite  | 

Abstract

Background: Type 1 diabetes or insulin-dependent diabetes is rising at 2–3% per year and contributes to almost 90% of juvenile diabetes and 10% of adult-onset diabetes. The presence of autoantibodies to glutamic acid decarboxylase-65 (GAD65), insulin antibodies (IA-2), islet cell antibodies, insulin antibodies, and zinc transporter 8 (ZnT8) indicates autoimmune destruction of beta cells and thus has the highest predictive value for type 1 diabetes. The risk of developing diabetes is also higher when an individual exhibits more than one antibody. Our study aimed to compare the predictive value of diabetes positivity for a specific type of autoantibody. Materials and methods: A retrospective study was conducted at the Global Reference Lab in Mumbai over a period of 3 years (from January 2020 to July 2023) on patients and children undergoing testing for diabetes type 1 profile. Data were analyzed based on age, gender, and antibody positivity. Results: Out of the 547 patients tested, 41.68% were female, and 58.32% were male. The positivity rate for the type 1 diabetes profile was 53.75%. Glutamic acid decarboxylase-65 antibodies were detected in 45.16% of patients, followed by IA2 insulin in 15.17% of patients. 48.68% of females were positive for GAD-65 compared to 42.63% positivity in males. The prevalence of GAD-65 positivity was higher in children up to 12 years of age, at 58.86%, followed by 43.50% positivity among the 19–30 years age group. Conclusion: Our study found that more than half of the individuals (53.75%) who underwent testing, exhibited type 1 diabetes antibodies. GAD-65 positivity rates were higher in females compared to males. Clinical significance: The study provides valuable insights into the prevalence and significance of type 1 diabetes antibodies in the Indian population, offering a foundation for targeted strategies in diabetes prevention and management.

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ORIGINAL RESEARCH ARTICLE

Shobha C Ramachandra, Akila Prashant, MN Suma, NK Swetha

Investigating Differences in Bicarbonate Levels: Exploring Discrepancies between Venous and Arterial Measurements and Evaluating Stability through Time-point Assessments

[Year:2023] [Month:September-December] [Volume:27] [Number:3] [Pages:3] [Pages No:50 - 52]

Keywords: Arterial bicarbonate, Preanalytical variables, Serum bicarbonate, Stability evaluation

   DOI: 10.5005/jp-journals-10054-0226  |  Open Access |  How to cite  | 

Abstract

Introduction: Evaluation of acid-base status is crucial in critical care settings, with bicarbonate serving as a key indicator of electrolyte distribution and anion deficit. This study explored the challenges and uncertainties surrounding the quantification and stability of bicarbonate levels, crucial for accurate clinical assessments. Methods: The study conducted in the clinical biochemistry laboratory of a tertiary care hospital involves a comparative analysis between serum and arterial bicarbonate levels. We examined serum bicarbonate in 31 patient samples, with concurrently calculated arterial values obtained from blood gas analysis reports of the same patients. Additionally, the stability of serum bicarbonate was assessed at different time intervals. Results: A significant correlation was observed between serum and arterial bicarbonate (r = 0.91), which was reinforced by Bland–Altman analysis. However, the stability assessment revealed a decrease in serum bicarbonate levels at 2 and 4 hours. Conclusion: This study contributes to the exploration of simplified methods for assessing acid-base status, particularly valuable in less-equipped conditions. The findings underscore the necessity for awareness among healthcare professionals regarding the impact of preanalytical variables, particularly uncapped tube storage, on serum bicarbonate levels.

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BRIEF RESEARCH COMMUNICATION

Surya Kantha Bugge, Tahniyath Fathima

Comparison of HbA1c Estimation by Enzymatic and HPLC Methods

[Year:2023] [Month:September-December] [Volume:27] [Number:3] [Pages:4] [Pages No:53 - 56]

Keywords: Diabetes mellitus, Glycated hemoglobin, High performance liquid chromatography, Hemoglobin A1c by enzymatic method

   DOI: 10.5005/jp-journals-10054-0223  |  Open Access |  How to cite  | 

Abstract

Introduction and objective: There are methods of HbA1c estimation that depend on different physical, chemical, immunological features of glycated hemoglobin. Numerous analytical techniques have been developed for assessing HbA1c in diabetes mellitus (DM), including immunoturbidimetry, boronate affinity chromatography, enzymatic assays, and high-performance liquid chromatography (HPLC) immunoassay. Notably, different estimation methods may yield disparate results. This study aims to conduct and compare two analytical techniques—specifically, the enzymatic method and HPLC method—to observe and analyze any variations in results within the same set of samples. Materials and methods: This is an observational cross-sectional study involving 100 EDTA samples. The study focused on the analysis of HbA1c using two distinct methods: Atellica CH 930 enzymatic hemoglobin A1c (HbA1c_E) from Siemens Healthineers and cation exchange HPLC from Bio-Rad Laboratories. Results: A strong robust correlation was observed between the two methods, as evidenced by a Pearson's Coefficient of 0.983. The Bland–Altman plot demonstrated a high level of agreement between the two techniques, with 95% of values falling within ±SD (standard deviation), indicating a strong concordance. Conclusion: This study establishes that both methods, Atellica CH 930 enzymatic hemoglobin A1c (HbA1c_E) and cation exchange HPLC, produced comparable results for HbA1c. Therefore, both analytical techniques are deemed suitable for the effective management of diabetes.

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CASE REPORT

Anannya Ghosh, Sanchayan Sinha, Neepa Chowdhury

Acute Dengue Myositis in a Pediatric Patient—An Uncommon Complication of a Common Disease: A Case Report

[Year:2023] [Month:September-December] [Volume:27] [Number:3] [Pages:3] [Pages No:57 - 59]

Keywords: Case report, Creatinine phosphokinase, Dengue, Myositis

   DOI: 10.5005/jp-journals-10054-0224  |  Open Access |  How to cite  | 

Abstract

Dengue fever is an arboviral disease caused by the dengue virus transmitted by the bite of female Aedes aegypti mosquitoes, affecting people worldwide often causing pandemics in Southeast Asian countries. Dengue viral infection symptoms range from flu-like illness to complications like pneumonia, and hepatitis, neurologic symptoms like encephalitis, myopathy, Guillain–Barre syndrome, phrenic neuropathy, subdural hematoma, and cerebral vasculitis. The possibility of skeletal muscle invasion causing myositis is another rare entity. We are reporting a case of dengue, with myositis presenting as muscle weakness, decreased power, and raised creatinine phosphokinase (CPK) level in a 6-year-old boy. The boy suffered from dengue viral fever diagnosed by positive NS1 antigen. Initially, the symptoms were like uncomplicated dengue fever but later he developed leg muscle pain, and decreased range of movements. The serum CPK level was increased and then the boy was diagnosed with myositis. Later with supportive treatment, he improved, the pain subsided, the power and tone of his leg muscles increased and the serum CPK level returned to normal.

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