Clinical Biochemistry Department Research Articles

Neutrophil gelatinase-associated lipocalin as a biomarker for detection of early renal impairment in Iraqi patients with multiple myeloma.

To evaluate the serum neutrophil gelatinase-associated lipocalin levels in multiple myeloma patients as an indicator of disease progression. The case-control study was conducted at the Clinical Biochemistry Department of the National Centre of Haematology, Mustansiriyah University, Baghdad, Iraq, from October 2020 to July 2021, amd comprised diagnosed multiple myeloma patients and healthy controls of either gender aged 40-60 years. Neutrophil gelatinaseassociated lipocalin and renal functions were measured for all patients in addition to obtaining a complete history and physical examination. Data was analysed using MedCalc. Of the 60 sujects, 30(50) were cases with mean age 64±2.1 years and 30(50%) were controls with mean age 60 ±3.2 years. There were 18(68%) males among the cases and 17(55%) among the controls. In the cases group, mean levels of creatinine, urea and neutrophil gelatinase-associated lipocalin were 1.62±0.85mg/dl, 55.56±28.05mg/dl and 389.39±116.12pg/mL, respectively. The corresponding values for the controls were 0.9518±0.1623mg/dl, 30.17±8.47mg/dl and 120.82±68'52pg/ml. The neutrophil gelatinase-associated lipocalin cutoff level >190pg/ml in multiple myeloma patients was strongly associated with renal impairment (p<0.001). Neutrophil gelatinase-associated lipocalin was found to be an accurate indicator of early kidney disease in patients with de novo multiple myeloma.

Agreement between routinely used immunoassays for thyroid function testing in non-pregnant and pregnant adults.

Thyroid function tests are common biochemical analyses, and agreement between the routinely used immunoassays is important for diagnosis and monitoring of thyroid disease. Efforts are continuously made to align the biochemical assays, and we aimed to evaluate the agreement between immunoassays used in a clinical laboratory setting among non-pregnant and pregnant adults. Cross-sectional study. Serum samples were obtained from 192 blood donors (non-pregnant adults) and from 86 pregnant women in the North Denmark Region with no known thyroid disease. Each sample was used for measurement of thyroid-stimulating hormone (TSH) with the routinely used automatic immunoassays in the regional Departments of Clinical Biochemistry (Alinity, Abbott Laboratories, Cobas, Roche Diagnostics, and Atellica, Siemens Healthineers) and reported as the median with 95% confidence interval (95% CI). In nonpregnant adults, the level of TSH was higher with Cobas and Atellica than with Alinity as reflected by median (Alinity: 1.39 mIU/L (95% CI: 1.30-1.51 mIU/L); Cobas: 1.57 mIU/L (95% CI: 1.48-1.75 mIU/L); Atellica: 1.74 mIU/L (95% CI: 1.61-1.83 mIU/L)). Similarly, a trend was seen towards higher median TSH with Cobas than with Alinity among pregnant women (Alinity: 1.90 mIU/L (95% CI: 1.37-2.82 mIU/L); Cobas: 2.33 mIU/L (95% CI: 1.69-3.62 mIU/L)). Results of thyroid function tests obtained with different immunoassays were not interchangeable when evaluated among pregnant and non-pregnant adults. The distinct differences are relevant for clinical decision making and emphasize the necessity of clinical laboratory information when different assays are used for diagnosis and monitoring of patients with thyroid disease.

Lipid Profile Perturbations Associated With Subclinical Hypothyroidism: A Descriptive Study.

Background Hypothyroidism is a prevalent endocrine disorder associated with dyslipidemia, which increases cardiovascular risk. Our study aimed to estimate the prevalence of dyslipidemia and subclinical hypothyroidism (SCH) and their correlation in a diverse population. Methods A descriptive cross-sectional retrospective analysis was conducted to assess the prevalence of dyslipidemia in patients with SCH. Data were collected over 19 months from the Clinical Biochemistry Department of a Moroccan university hospital. A total of 447 patients were included based on comprehensive lipid profile andthyroid-stimulating hormone (TSH) assessments, and normal free thyroxine (FT4) levels. Lipid profile and TSHmeasurements followed standardized procedures using the Cobas Roche® 6000 system (Roche Diagnostics Corporation,Indianapolis,USA). Dyslipidemia and SCH were defined according to established thresholds recommended by reputable organizations. Statistical analyses were performed using SPSS version 23.0 (IBM Corp., Armonk, USA)and Microsoft Excel (Microsoft Corporation, Redmond, USA), with significance set at p <0.05. Results In the total population (447 individuals), the prevalence of dyslipidemia was approximately 42.05% (N = 188), with hypoHDLemia being most prevalent at approximately 31.31% (N = 140). The prevalence of SCHwas approximately 12.75% (N = 57), with women constituting approximately 7.6% and men approximately 5.15%. In the euthyroid group 1 (N = 390), the prevalence of dyslipidemia was approximately 40.76% (159 individuals), while in the hypothyroid group 2 (N = 57), it increased to approximately 50.87% (N = 29). Hypertriglyceridemia was more prevalent in Group 2, with a prevalence of approximately 21.05% (N = 12), compared to Group 1, which had a prevalence of approximately 13.84% (N = 54). Additionally, hypoHDLemia was notably higher in Group 2, with a prevalence of approximately 38.59% (N = 22), compared to Group 1, which had a prevalence of approximately 30.25% ( N = 118). The chi-square test revealed a significant association between SCH and dyslipidemia (χ2 = 1.427, p <0.05). The calculated odds ratio (OR) of 1.5 (p <0.05) indicates that individuals with SCHare 1.5 times more likely to have dyslipidemia compared to those without SCH. Conclusion In conclusion, our study provides valuable insights into the prevalence of dyslipidemia and its association with SCHin our patient population. We observed a notable prevalence of dyslipidemia among individuals with SCH, characterized by elevated levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). Importantly, while chi-square tests revealed a significant association between SCH and dyslipidemia, logistic regression analyses did not confirm a statistically significant correlation after adjusting for potential confounders.

Determination of Reference Interval for Serum Homocysteine, Magnesium, and Uric Acid from Tertiary Care Hospital Data By the Bhattacharya Method

Abstract Introduction: Direct ways of establishing reference intervals for analytes are time-consuming and costly. Bhattacharya analysis is an indirect way to mathematically derive reference intervals from the results of analytes in a hospital database and is practically a simple and inexpensive alternative to direct methods. Methods: Data of serum uric acid, magnesium, and plasma homocysteine levels measured in the department of clinical biochemistry over 3 years were extracted from the hospital database along with the age, gender, and location of the patients. Bhattacharya analysis was performed by identifying underlying Gaussian distribution within the non-Gaussian distribution of the patient data by log transformation of the distribution of the data. Reference intervals for each of the analytes were calculated from the identified Gaussian distribution. Results: The reference interval for serum uric acid was 1.49–8.97 mg/dL in men and 2.13–6.14 in women, serum magnesium in adults was 1.19–3.21 mg/dL, and plasma homocysteine in adults was 4.6–21 μg/dL. Conclusion: Using Bhattacharya analysis, we were able to derive reference intervals for analytes from our hospital data.

Analysis of biochemical analytes using six sigma metrics with two analyzers at an Indian lab setting.

A zero defects goal was implemented in the clinical laboratory settings using a six-sigma model. Daily Internal Quality Control (IQC) and external quality control data from April-September 2023 was extracted to calculate the sigma metrics of 21 biochemical analytes based on Total Error Allowable (TEa), % bias and co-efficient of variation percent (CV%). A retrospective comparative study was conducted in the department of Clinical Biochemistry at Kanva Diagnostic Services Pvt. Ltd, Bengaluru, India. The analytical performance of the 21 biochemical analytes was tested on Cobas 6000 and C311 analyzers. Quality Goal Index (QGI) and root cause analysis was calculated to infer the reason for the deviation of six sigma. Method decision charts were plotted to show the comparison of the problem analytes on both the analyzers. On Cobas 6000 at level 1 IQC, out of 21 analytes, 10 analytes showed σ>6 and 10 analytes showed σ 3-6 and on C311, 15 analytes which showed σ>6 and 6 analytes that showed σ 3-6. On Cobas 6000 at level 2 IQC, out of 21 analytes, 12 analytes showed σ>6 and 8 analytes showed σ 3-6 and on C311 17 analytes showed σ>6 and 4 analytes showed σ 3-6. Creatinine failed to meet minimal sigma performance at both levels of IQC on Cobas 6000.

Autoimmune thyroid status in subclinical thyroid disorders in patients attending a tertiary care center in Nepal: a hospital-based cross-sectional study

BackgroundThyroid dysfunction is the leading endocrine disorder worldwide. Iodine deficiency disorders, which were once the major etiology of thyroid dysfunctions, now have been succeeded by autoimmune thyroid diseases with the rise in aberrant salt ionization protocols. This study endeavors to access the level of thyroid autoantibodies viz. anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (TGA), and anti-thyroid stimulating hormone receptor (TRAb) in individuals with subnormal thyroid profiles.MethodsThis hospital-based cross-sectional study was conducted at the Department of Clinical Biochemistry, Tribhuvan University for a period of six months. Using non-probability (purposive) sampling method, a total of 60 patients were enrolled with subnormal thyroid profiles to include the population who have not yet started medication. Thyroid hormones (free T3, free T4, TSH) and thyroid antibodies (anti-TPO, TGA, and TRAb) were measured. For non-parametric data, Chi-square test and Kruskal-Wallis test were used. Spearman’s correlation was done to determine the association between variables.ResultsOut of 60 participants, the majority of the population between 25 and 44 years were diagnosed with thyroid dysfunction with female preponderance. Among all, 40% (n = 24) had subclinical hyperthyroid states while, 60% (n = 36) had subclinical hypothyroid states, and 75% (n = 45) of the total exhibited positive thyroid antibodies. In subclinical hypothyroid patients with TSH above 10 µIU/ml, anti TPO (58.5%) and TGA (66.7%) positivity were highly prevalent. On the other hand, TRAb was exclusively positive in hyperthyroid condition (50% among the group) which is by far the first of its kind reported in Nepal.ConclusionThe rise in autoimmune thyroid disease among the Nepalese population infers that addressing iodine deficiency simply through salt iodinization may not be adequate to deal with the rising burden of thyroid disorders, especially in iodine-depleted areas. Also, the increasing prevalence of thyroid autoantibodies positivity in subclinical hypothyroidism in the Nepalese population accounts for the arduous screening and monitoring of autoimmune thyroid disorders in Nepal.

Caffeic Acid Phenethyl Ester Reduces the Adverse Effects of Nicotine on the Endometrium.

Tobacco smoke contains various toxins that negatively affect the human reproductive system. Caffeic acid phenethyl ester (CAPE), a potent antioxidant, has protective effects on the reproductive system against oxygen-free radicals, methotrexate, and pesticides. Herein, the effect of CAPE on some key markers of endometrial receptivity has been evaluated. A cross-sectional study was conducted during 2018-2019 in the Department of Clinical Biochemistry, School of Medicine, Fasa University of Medical Sciences (Fasa, Iran). Primary endometrial cells were divided into five groups, namely control, nicotine, CAPE, vehicle, and nicotine+CAPE. Real-time polymerase chain reaction (PCR) and methylation-specific PCR were performed to evaluate gene expressions and methylation, respectively. Appropriate doses of CAPE and nicotine were determined using the MTT assay. Data were analyzed using SPSS software (version 16.0) with a one-way analysis of variance. P<0.01 was considered statistically significant. The fold change was calculated using the 2-∆ΔCT method. Treatment of cells with nicotine significantly reduced the expression of C-X-C motif chemokine ligand 12 (CXCL12), fibroblast growth factor 2 (FGF2), and vascular endothelial growth factor A (VEGF-A) genes (P<0.0001). However, the expression levels increased significantly when treated with nicotine+CAPE (P<0.0001). Despite the reduced CXCL12 gene expression in cells treated with nicotine, CXCL12 was unmethylated in all study groups, indicating that the methylation status of the CXCL12 gene was not affected by nicotine or CAPE. CAPE can be a suitable agent to protect female smokers from the harmful effects of nicotine. This manuscript is available as a preprint on the Research Gate website.

Editorial introductions.

Editorial introductions.

Monitoring and Root Cause Analysis of Clinical Biochemistry Turnaround Time at a Tertiary Care Institute.

Most laboratories around the world have focused on improving the analytical quality of laboratory tests. Laboratory turnaround time (TAT) is often left unnoticed and under-recognised in the healthcare setting. Both patients and clinicians are more interested in receiving rapid, reliable, and accurate results. This can be achieved by improving the TAT through the identification of the causes that lead to delayed TAT. This prospective study aims to identify the cause of delayed TATs within the outpatient department and implement corrective strategies to overcome them. A total of 214 samples were received. The study was conducted for a period of two years; of all the samples received, 154 were from the outpatient department, and 78 samples exceeded the expected TAT. The samples were analysed in the clinical biochemistry department of the hospital. The time spent at each station was determined using an internal computer system, which was also used to identify the samples that exceeded TATs. The primary outcome of the study was to identify the number of samples exceeding TAT and the causes of it. Upon implementation of corrective measures and root cause analysis, the TATs were reduced from 80-88% to 11-33%. After analysing the duration of time for the samples that exceeded TAT, 45.1% and 37.5% exceeded 30 minutes in Year 1 and Year 2, respectively. Only 3.2% and 6.2% exceeded five hours in Year 1 and Year 2, respectively. Furthermore, using root cause analysis, it was found that 12% of the delay was due to increased waiting time or sample collection, 14% included other causes such as outsourcing of samples, and 18% of the delay was due to pre-analytic processing time. Our study concludes that TAT is an important quality assessment tool within the laboratory setting, and with proper identification of causes, it can be improved. Although monitoring TAT is a tedious process that mandates tremendous efforts, with the presence of real-time monitoring, improving TAT is an achievable goal. This, in turn, can improve patient treatment outcomes and clinician satisfaction.

Metabolic and biochemical profile in women with polycystic ovarian syndrome attending tertiary care centre of central NEPAL

BackgroundPolycystic Ovarian Syndrome (PCOS) is a common endocrinopathy in women of reproductive age group and is highly associated with an increased risk of diabetes, hypertension, cardiovascular disease, and hyper estrogen-related malignancies in women with PCOS. This study was intended to assess the metabolic and hormonal profile of the patients with polycystic ovarian syndrome attending a tertiary care hospital.MethodologyA descriptive cross-sectional study was conducted among 107 women diagnosed with polycystic ovarian syndrome from the Department of Clinical Biochemistry of Tribhuvan University and Teaching Hospital. Descriptive analysis was performed to determine the socio-demographic characteristics of the participants. Bivariate analysis was conducted to determine using a t-test for comparing means between two groups and ANOVA for comparing the hormonal and metabolic parameters.ResultsThe mean age of the participants was 27 ± 4 years. This study showed that blood pressure was significantly higher in overweight and obese women (p = 0.001). The obese group had significantly higher serum TSH than the normal group (10.04 vs. 2.73, p = 0.001). Abnormal glucose and hyperinsulinemia were present in 4% of the patients, while 40% had Vitamin D deficiency. Hypothyroidism (TSH ≥ 4.5 mIU/ml) was found in 11% of the PCOS participants with a mean value of 6.65 ± 21.17 mIU/ml. Hyperprolactinemia ≥ 26.8 ng/ml was depicted in 21% of the study population with a mean value of 37.25 ± 21.86 ng/ml.ConclusionOur study demonstrated that PCOS is most commonly prevalent in young women of the reproductive age group which can lead to reproductive, metabolic, and oncological complications in the long term. LH/ FSH ratio was found to be significantly deranged indicating that PCOS should be diagnosed and treated early in the adolescent age group.

Associations between education level, blood-lipid measurements and statin treatment in a Danish primary health care population from 2000 to 2018

Objective To examine whether education level influences screening, monitoring, and treatment of hypercholesterolemia. Design Epidemiological cohort study. Setting Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre. Subjects Cholesterol blood test results ordered by general practitioners in Greater Copenhagen were retrieved from 2000-2018. Using the International Standard Classification of Education classification, the population was categorized by length of education in three groups (basic education; up to 10 years, intermediate education; 11-12 years, advanced education; 13 years or more). The database comprised 13,019,486 blood sample results from 653,903 patients. Main Outcome Measures Frequency of lipid measurement, prevalence of statin treatment, age and comorbidity at treatment initiation, total cholesterol threshold for statin treatment initiation, and achievement of treatment goal. Results The basic education group was measured more frequently (1.46% absolute percentage difference of total population measured [95% CI 0.86%–2.05%] in 2000 and 9.67% [95% CI 9.20%–10.15%] in 2018) over the period compared to the intermediate education group. The advanced education group was younger when receiving first statin prescription (1.87 years younger [95% CI 1.02–2.72] in 2000 and 1.06 years younger [95% CI 0.54–1.58 in 2018) compared to the intermediate education group. All education groups reached the treatment goals equally well when statin treatment was initiated. Conclusion Higher education was associated with earlier statin prescription, although the higher educated group was monitored less frequently. There was no difference in reaching treatment goal between the three education groups. These findings suggest patients with higher education level achieve an earlier dyslipidemia prevention intervention with an equally satisfying result compared to lower education patients. Key Points Little is known about the role of social inequality as a possible barrier for managing hypercholesterolemia in general practice. Increasing education level was associated to less frequent measurement and less frequent statin treatment. Patients with higher education level were younger, and less comorbidity at first statin prescription. Education level had no effect on frequency of statin treatment-initiated patients reaching the treatment goal was found.

First decade anniversary of the United Kingdom National Alkaptonuria Centre.

First decade anniversary of the United Kingdom National Alkaptonuria Centre.

Parathyroid hormone reference intervals in adults using second- and third-generation assays

Parathyroid hormone (PTH) is a routine biochemical analysis, and it varies whether a second- or third-generation assay is used. Information on the levels obtained with different assays and evidence to substantiate local assay-specific reference ranges are important to inform clinical practice. Prior to a shift from the second- to the third-generation PTH assay (Cobas 8000, Roche Diagnostics) in the Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark, a total of 59 EDTA-plasma samples were collected for method comparison (Passing–Bablok). Furthermore, 120 EDTA-plasma samples were randomly obtained from adult blood donors and used for the establishment of reference intervals using the third-generation PTH assay (Cobas 8000, Roche Diagnostics) and two second-generation assays (Atellica, Siemens Healthineers; Alinity, Abbott Laboratories). Method comparison (Cobas 8000, Roche Diagnostics) showed lower levels with the third-generation (y) as compared to the second-generation assay (x) depending on the measurement range (PTH < 10 pmol/L: y = 0.8 (95% CI: 0.7; 0.9) x + 0.3 (95% CI: 0.2; 0.5), PTH ≥ 10 pmol/L: y = 0.6 (95% CI: 0.5; 0.6) x + 3.2 (95% CI: 1.1; 5.2)). Method-specific reference intervals (2.5 and 97.5 percentiles) after the exclusion of samples (n = 31) with 25-hydroxy-vitamin D below 50 nmol/L were: 1.8–8.5 pmol/L (second-generation, Atellica, Siemens Healthineers); 2.4–10.9 pmol/L (second-generation, Alinity, Abbott Laboratories), and 1.8–7.0 pmol/L (third-generation, Cobas 8000, Roche Diagnostics). PTH levels with second- and third-generation assays are not interchangeable. Clinicians should be informed when a laboratory assay is changed, and method-specific reference ranges are needed.

Editorial introductions.

Editorial introductions.

Impact of age-dependent red blood cell parameters on α-globin gene genotyping in children.

When screening for α-thalassemia in children, adult cut-offs for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) are generally applied to guide genetic evaluation. However, the normal ranges for MCV and MCH are lower in children than in adults, so we hypothesized that using age-matched cut-offs could lead to a more rational diagnostic strategy. The aim of this study was to evaluate if age-matched cut-offs could be applied advantageously. Data on children referred to a hemoglobin fractionation at the Department of Clinical Biochemistry, Aarhus University Hospital between 2016-2021 were identified in the laboratory information system. α-globin gene (HBA1/HBA2) genotyping was performed using multiplex gap-polymerase chain reaction. A total of 387 children were identified. HBA1/HBA2-genotyping was performed in 207 children (53%), and α-thalassemia was diagnosed in 47 children (23%) with -α3.7/αα being the predominant genotype (13%). We found that 23 children had MCV and MCH levels in the normal age-matched range, and two of these children (9%) were α+ thalassemia carriers with three functional α-globin genes. Using age-specific cut-off levels resulted in a reduction of 23 (11%) genotypes performed. In conclusion, applying age-matched cut-offs for MCV and MCH when screening children for α-thalassemia lead to 11% fewer genotypes performed while 9% carriers of α+ thalassemia (of the medically innocuous genotype -α3.7/αα) would have been overlooked.

Reagent Lot Variation Assessment: Establishing the Suitable Acceptability Criteria and Implementing an Efficient and Cost-effective Approach

Abstract Introduction/Objective When reagent lot number change for a particular assay it is hoped that the results obtained from the new lot are comparable with those of the old lot and so will not lead to misleading clinical conclusions based on either the reference intervals or previous results on the same patient. This study has criticality evaluated and compared various methods of establishing reagent lot-to-lot verification acceptability criteria to determine the most suitable approach in Sidra Medicine Clinical Biochemistry Department in order to implement an efficient and cost-effective method of verifying new reagent lot numbers. Methods/Case Report Several methods and approach for establishing in-house acceptable criteria for determining reagent variations were critically evaluated. These methods include the use of CLSI EP26-A guidelines, proficiency testing or external quality assessment (EQA) total allowable errors (TeA) and internal quality control (IQC) in-house target SD and CV reflecting the current assay performance. A user friendly statistical template was also produced to be able to improve fhe current workflow, data entry, presentation and documentation of each test with a new reagent lot number approved and implemented for patient testing. Results (if a Case Study enter NA) A full version of Reagent Lot Variation Acceptance Table was produced showing comprehensive established criteria based from methods mentioned above. IQC and patient comparability results are entered in an excel template which automatically calculates the differences and shows if the new lot number passed or failed based on the in-house acceptability criteria established. The reagent lot-to-lot verification template is updated each month using complex excel rules to keep the acceptability limits in accordance with the most current in-house IQC target mean and SD based from the most recent monthly IQC reviews. Conclusion The comparison of different reagent lot variation acceptability criteria indeed raised awareness of the efficiency and practicality of performing reagent lot-to-lot verification. CLSI EP26-A approach was observed to have the least sample number requirement. However, one patient sample for comparison study seems not enough to justify the approval and implementation of the new reagent lot number to consider the assays AMR. The IQC SD and CAP Total Allowable Error (TeA) acceptability criteria are more effective since there is more number of patient samples used for comparability across the assays AMR.

DISTANCE EDUCATION AS AN ALTERNATIVE FORM OF LEARNING IN A PANDEMIC CONDITION

The aim of the research is to analyze the relationship between the success and frequency of the distance learning server Moodle using in the study of medical students, as well as to assess the features and identify major problems in training during COVID-19 pandemic. The results of 200 medical students total success have been analyzed. Students’ education achievement was assessed as a factor in determining the training success in the context of relationship with the number of Moodle distance learning server visits. Two subgroups have been analyzed (100 people in each) depending on the departments: сlinical discipline (propaedeutics of іnternal medicine) and theoretical (biochemistry). Statistical analysis of students’ activity in Moodle system revealed high correlation between the frequency of the platform visits and students’ educational success at the Department of Propaedeutics of Internal Medicine. A similar pattern is observed in the analysis of the correlation between the use of Moodle and learning outcomes in theoretical disciplines by the example of Bioorganic and biological chemistry and clinical biochemistry department. Thus, in order to prevent the spread of acute respiratory disease COVID-19, an distance education elements should be implemented; the using of the Moodle platform helps to increase medical student’s educational success.

Comparison of the Effects of Cryotherapy and Swimming in Cold Water – Winter Swimming on Chosen Morphological and Biochemical Blood Indices and Factors Released by Brown Adipose Tissue

Introduction: Whole-body cryotherapy and winter swimming are applied to induce physiological, organ-related, and systemic defence responses that are beneficial and effective in maintaining or restoring human body homeostasis. Purpose: The aim of the study was to evaluate blood morphological and biochemical indicators in men and women exposed to whole-body cryotherapy and winter swimming. Material and methods: From all participants (n=70) before starting 20 whole-body cryotherapy sessions and after completing the 20 whole-body cryotherapy sessions (woman n=15, men n=15), at the beginning of the winter swimming season (November) and at the end of the winter swimming season (April) (woman n=15, men n=15), and in the control group (woman n=10, men n=10), fasting blood samples were collected from an ulnar vein into vacuum tubes. Blood morphological and biochemical indicators and brown adipose tissue were determined in the Blood Physiology Department of the Central Research and Development Laboratory at the University of Physical Education in Krakow and in the Department of Analytics and Clinical Biochemistry of the Krakow Branch of Maria Sklodowska-Curie National Research Institute of Oncology. Results: In both sexes included in the study, both whole-body cryotherapy and winter swimming induce changes in selected peripheral blood morphological and biochemical indicators, mainly in the blood count, proteinogram, and chloride concentrations. The increase in the brown adipose tissue-released fibroblast growth factor-21 (FGF-21) under the influence of whole-body cryotherapy occurs in females. In contrast, no statistically significant changes were found for Nrg4. Both whole-body cryotherapy and winter swimming result in decreased values of red blood cells, haemoglobin, and iron, with sex-dependent variation. Conclusions: Cold in the form of systemic cryotherapy, similarly to winter baths, affects changes in blood morphological and biochemical parameters, while the release of FGF21 in brown adipose tissue was noted only after systemic cryotherapy.

Value of Genetic Testing for Lipoprotein(a) Variants

Value of Genetic Testing for Lipoprotein(a) Variants

STUDY OF LIVER FUNCTION PARAMETERS IN PREGNANT WOMEN ATTENDING A TERTIARY CARE CENTRE

Introduction: Changes in liver biochemical prole are normal during pregnancy. However, severe liver disease, although rare, can occur and must be recognized at an early stage to reduce morbidity and mortality for mother and infant.The pathological derangement in the liver functions may be related to pregnancy or may coexist with pregnancy and may be divided into three major groups. We aim to nd the incidence and possible (pregnancy-specic liver disorder and pregnancy non-specic liver disorder) of alteration in liver function tests (LFTs) in pregnant women attending tertiary care center. Aim and Objectives: To determine the association between altered Liver function tests and Possible causes of liver disorders in Pregnancy. Materials and Methods: Sampling data was collected over a period time of 1 Year. The study was done at the Clinical Biochemistry Department, tertiary care rural center. All data will be collected from the solace-laboratory Information system of the clinical biochemistry register at the central diagnostic laboratory. The sample size of the study is 83. Then, we plot the data according to the incidence of variable causes of liver disorderspecic and non-specic to pregnancy, also calculate the degree of alteration in LFTs in particular causes. Result: This study included a total of 83 individual cases (females only-age 18 to 35 years). 41 (49%) out of 83cases were related to pre-eclampsia, 12 (14%) cases related to HELLP syndrome, 2 (2%) cases related to AFLP, 3 (4%) cases related to ICP, 7 (8%) cases related to viral hepatitis, 3 (4%) cases related to Hyperemesis, 8 (10%) cases related to Eclampsia &amp; 7 (8%) cases related to Miscellaneous. ALP level increase in viral hepatitis (mean 585.4 u/l, SD± 68.5), pre-eclampsia (mean 239.28 U/L, SD ± 38.25) and decrease level in miscellaneous Causes (mean 82.2 u/l, SD± 37.4) &amp; ICP (mean 103.3 u/l ,SD±30.0). The AST level was rise in viral hepatitis (mean 781.8 µ/l, SD ± 46.14), AFLP (mean 708.5 u/l, SD ± 12.0), ICP (mean 100 u/l, SD ± 4.35), preeclampsia (mean 123.3 u/l, SD ± 22.0) and remain normal in miscellaneous cause (mean 21.2 u/l, SD ± 8.22) &amp; hyper emesis (mean 25.66 u/l, SD ± 4.50). Conclusion: Alterations in Liver function test results were due to Liver disease in pregnancy include -a 3-to-4-fold rise in the level of alkaline phosphatase (ALP) in viral hepatitis, Pre-eclampsia &amp; AFLP. An increase in the total bilirubin level was found in viral hepatitis, pre-eclampsia &amp; HELLP syndrome, whereas a downward trend was seen in the levels of serum albumin and total proteins. Serum ALT &amp; AST levels become a rise in Pre-eclampsia, Viral hepatitis, Eclampsia, and also AFLP. It was found that serum AST level was in normal limits in hyperemesis &amp;miscellaneous.