Department Of Biochemistry Research Articles

Early Blood Gas Analysis in SARS-COV-2 Infected Patients Admitted to SMHS Hospital: A Tertiary Care Hospital in Kashmir

Inroduction: Blood gases are a measurement of how much oxygen and carbon dioxide is in blood. These determine the acidity of blood. The blood gas testing is generally used for detecting and monitoring lung and kidney problems. The blood gas testing measures partial pressure of oxygen (o2), partial pressure of carbon dioxide (CO2),oxygen saturation(O2Sat), bicarbonate(HCO3) concentration .
 Materials and Methods: Here in study Patients aged more than 18 years confirmed Covid 19 positive by reverse transcription, PCR (RT-PCR). Patients suffering from moderate to severe Covid 19 as per WHO diagnostic guidelines and underwent at least one ABG were included in the analysis. The ABG test was done on ABG analyzer in department of Biochemistry, SMHS hospital. All the data which was related to study was gathered and recorded in case record forms using files. As well as reports of patients from medical record section.
 Results: Alkaline pH was found in 57.33% individuals.36% individuals were having normal pH and the percentage of individuals having acidic pH was 6.66%. Low PaO2 was found in 45.33% individuals. Normal PaO2 levels were found in 21.33% and high PaO2 levels were found in 33.33% individuals .Low PaCO2 (<35 mmHg) were found in 56%, normal (35-45mmHg) levels were found in 37.33% and high levels (>45mmHg) were found in 6.66%. Low HCO3- (<22mmol/L) were found in 16%, normal (22-26mmol/L) in 38.66% individuals and high (>26mmol/L) were found in 45.33% individuals would be expected in the case of respiratory alkalosis.
 Conclusion: Regular ABG monitoring can aid in the early detection of silent hypoxia, and respiratory injury. With early management start-up, many lives can be spared with early diagnosis.

Determination of Vitamin K2, Lipoprotein (a) and N-Terminal pro Brain Natriuretic Biomarkers in Diabetic Hypertensive Patients with Acute Myocardial Infarction for Clinical Intervention

Background: Severe Myocardial Infarction is a highly stark manifestation of heart illness, often accompanied with additional complications such as diabetes mellitus (DM) and hypertension (HTN). The hormone within the body enables glucose to enter the cells and burn them up as fuel. HTN is a common vascular disorder that represents a major cardiovascular condition. Methods: The study was conducted at the Biochemistry Department of the College of Medicine from April 2022 to May 2023 and used the Human Vit K2 ELISA Kit, Human Lp(a) ELISA Kit, and Human N-terminal ProBST ELISA Kit to estimate the serum levels of vitamin K2, lipoprotein (a) (Lp(a)), and N-terminal of the Pro brain natriuretic peptide (NT-proBNP). Results: The results showed a important decrease in VK2 levels in AMI patients with DM and HTN than the other two groups (less than AMI patients group with and without HDL-c). On the other hand, Lp(a), and NT-pro BNP levels were significantly increased in AMI patients with DM and HTN than the other two groups (less than AMI patients group with no DM and HTN). As the diagnostic accuracy of tests increased, the area under the ROC curve for NTproBNP for diagnosing AMI achieved the highest 0.988. NTproBNP showed a promising ability to differentiate AMI patients from DM+ HTN group with 0.971 (AUC). Conclusions: In diabetic hypertensive patients with acute myocardial infarction, a low level of vitamin K2 and a high level of lipoprotein(a) might be risk markers for the onset of myocardial infarction.

Comparative Study of Serum Calcium Level Between Postmenopausal and Premenopausal Women

In postmenopausal women, more significant bony consequences are associated with low blood calcium levels. A observational cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2014 to June 2015. Serum calcium levels were compared between postmenopausal women as cases and premenopausal women as controls. The study sample size was 100 of which 50 were postmenopausal, and 50 were premenopausal. Mean (±SD) of serum calcium level was significantly higher in the premenopausal group than in the postmenopausal group. Serum calcium level was 8.66±0.43 mg/dL in postmenopausal women and 9.12±0.59mg/dL in premenopausal women. Both the values were within the normal reference range, but the difference was statistically significant with a p-value of 0.001. By this research work, it is observed that postmenopausal women are more prone to develop osteoporosis with a decreased serum calcium concentration. Routine check-up of this biochemical parameter may provide valuable information for preventing osteoporotic fractures in postmenopausal women.
 Bangladesh J Med Biochem 2019; 12(1): 1-5

Relation of Serum Bilirubin in Physiological Range with Spot Urine Albumin to Creatinine Ratio and eGFR Among Diabetic Patients with or without Nephropathy

Recent studies have suggested a potential role of bilirubin as an antioxidant to protect diabetic patients from hyperglycemia-induced oxidative stress thereby preventing diabetic complications. Diabetic nephropathy is a serious microvascular complication which is determined by increased urinary albumin to creatinine ratio and reduced eGFR. The present work aimed to study the relation of the simple biochemical parameter of serum bilirubin level with the estimated glomerular filtration rate (eGFR) and spot urine albumin to creatinine ratio in diabetic patients with or without nephropathy. This cross sectional study was done in the department of Biochemistry and Molecular Biology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Academy from July 2017 to June 2018. We have taken 63 diabetic patients without nephropathy and 63 diabetic patients with nephropathy.Data about clinical and biochemical parameters (blood pressure, BMI, fasting serum glucose, estimated GFR, serum bilirubin and spot urine ACR etc.) were measured by appropriate methods. We used student’s t test and Pearson’s correlation coefficient to detect the relationship of serum bilirubin with other variables All statistical tests were considered at 5% level of significance. We found diabetic patients with nephropathy have significantly lower serum bilirubin (p<0.001) than diabetic patients without nephropathy (0.46±0.18 and 0.64± 0.21 mg/d respectively). Pearson’s correlation test showed that serum bilirubin positively correlated with eGFR (r=0.312, p=0.013) in diabetic patients with nephropathy. This study concluded that low serum bilirubin level is associated with eGFR in diabetic patients with nephropathy.
 Bangladesh J Med Biochem 2019; 12(2): 16-22

Study of Correlation of Serum Adiponectin Concentration with Different Lipid Profile Components

Adiponectin is a hormone, secreted from adipose tissue. It is inversely correlated with body fat mass. This hormone has also anti-inflammatory and ant-iatherogenic properties. This study was purposed to explore the relationship between serum adiponectin concentration and lipid profile. This cross-sectional analytical study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2016 to February 2017. By non-probability sampling, a total of 156 study subjects were selected from apparently healthy adult individuals attending outpatient department of BSMMU. Serum adiponectin level positively correlated with serum HDL cholesterol (r=0.246, p value 0.002) concentrations and negatively correlated with serum total cholesterol (r=-0.171, p value 0.033) and serum triacylglycerol level (r=-0.3, p value 0.00). So, from this study it can be concluded that adiponectin has an important role in the metabolism of lipid profile components and responsible for controlling the concentration of serum lipid profile components. When adiponectin concentration of blood increases it is responsible for raised serum HDL-C concentration and decreased total cholesterol and triacylglycerol concentration.
 Bangladesh J Med Biochem 2019; 12(1): 6-10

Demographic analysis of hearing impairment based on various parameters in patients with cochlear implant.

To analyse the demographic and clinical variables in children having undergone cochlear implant surgery because of deafness. The cross-sectional study was conducted from January to November 2022 at the Centre for Research in Experimental and Applied Medicine laboratory of the Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with the Ear, Nose and Throat Department of Combined Military Hospital, Rawalpindi, and comprised children of eith gender aged up to 10 years who had received cochlear implant. Data was collected through questionnaire-based detailed interviews. Syndromic Hearing Loss, Non-Syndromic Hearing Loss, and Acquired Hearing Loss were identified among the subjects. Data was analysed using SPSS 22. Of the 250 cases, 147(58.8%) were boys, 146(58.4%) were aged 0-5 years, 219(87.6%) had prelingual onset of disease, and 202(80.8%) had a non-progressive disease course. In 203(81.2%) cases, normal developmental milestones were seen. Parental consanguinity was observed in 219(87.6%) cases. However, 63(25.2%) patients had a first-degree relative who had a history of deafness. In 170(68%) cases, hearing loss was hereditary, whereas in 80(32%) it was acquired. Meningitis was the most commonly identified risk factor 55(68.75%). Acquired risk factors and family history had significant association with hearing loss (p<0.05). Speech perception significantly improved in all 219(100%) patients with prelingual hearing loss who underwent cochlear implantation. Majority of the cases were found to be male, had a prelingual disease onset and a non-progressive disease course. Family history was a significant factor, while meningitis was the most common acquired cause of hearing loss.

EFFECTIVENESS OF THE LEVEL OF SERUM CALCIUM IN HYPO- AND HYPERTHYROIDISM PATIENTS AT TERTIARY CARE HOSPITAL, KANPUR

Introduction: Hypothyroidism and hyperthyroidism are two primary pathological conditions that involve thyroid glands. Thyroid dysfunction amends calcium metabolism thereby necessitating regular monitoring of calcium levels. Aim: The aim of the study is to find the prevalence of the level of serum calcium in hypo- and hyperthyroidism patients at tertiary care hospital Kanpur. Methods: The Department of Biochemistry carried out this research at RMCH and RC, Kanpur, for 1 year between February 2019 and January 2020. In our study, we have taken 150 patients and classified them into three groups. Each group belonging to 50 subjects in total 100 subjects were suffering from thyroid. The left 50 subjects were normal and used as control for making a better understanding of hyper- and hypothyroidism. After study there thyroid profile and calcium level from the standard method. 5 mL of fasting venous blood sample was collected from each patient. In the present study, following analyses were conducted, thyroid function test (T3, T4, and thyroid-stimulating hormone [TSH]) and serum calcium. Result: Out of 150 samples, in the present investigation, we find that the mean age group was 20–30-year-old patients included. Which number was higher in the group 1st (hyperthyroidism.) and 2nd group patients belonging 20–30 years but our value also indicated the same number in the age group 41–50-year hypothyroidism, whereas in the control group, we took that maximum age group was 20–30 years old, while investigated hyperthyroid patients, we observed mean value of T3=1.23±0.67, T4=8.15±2.43, TSH=0.16±0.13, and calcium 11.94±0.53. During the investigation of hypothyroidism patients, we find the following values of T3=0.87±0.27, T4=7.53±2.05, TSH=50.93±55.77, and Ca=7.53±0.75. Conclusion: In our study, we found that serum calcium is affected by the thyroid hormones. Whenever there are any thyroid hormone disturbances, alterations in the levels of serum calcium should be looked for to prevent any abnormalities from occurring.

Determination of Glyoxalase-1 levels and Identification of Genetic Variants in GLO1 Gene in Patients of Diabetic Nephropathy.

To determine the association of diabetic nephropathy with glyoxalase-1 enzyme levels and a genetic missense variation (SNP rs4746) in its gene (GLO-1). This cross-sectional comparative study was conducted at the Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi from November 2020 to December 2022. One hundred patients and one hundred and thirteen healthy controls were enrolled using the nonprobability convenience sampling method. Medical history and 10ml blood were obtained from each individual after written informed consent. Blood samples were subjected to biochemical tests and DNA extraction which was later used for single nucleotide polymorphism (SNP) analysis (C332C variant of rs4741 GLO-1 gene) using Tetra primer ARMS PCR and gel electrophoresis. Glyoxalase-1 enzyme activity in serum was measured using ELISA. There was a significant difference in serum glyoxalase-1 levels in the two groups (p-value< 0.001). The patient group had lower levels (16.24 ± 22.51mg/dl) of glyoxalase-1 as compared to the control group (48.70 ± 42.54mg/dl). In genotypic analysis, 98 out of 100 control individuals had AA genotype-while only one had CC and another AC genotype. In the patient group, 94 out of 100 patients showed AA genotype, three AC, and three CC genotypes. As the statistical significance (p-value) was 0.37, there was no significant association found between AC or CC genotype and diabetic nephropathy. Glyoxalase-1 levels are linked to the development of diabetic nephropathy in our patients while a known missense variant rs4746 in the GLO-1 gene is not associated with increased risk.

Association between Serum Ferritin and Insulin Resistance Markers with Distinct Glycemic Profiles in an Adult Bangladeshi Population

Background: Type 2 diabetes mellitus (T2DM) is a global health concern. Around 56% of subjects in Bangladesh go undiagnosed, increasing the risk of stroke and cardiovascular issues. Iron stores' impact on diabetes is gaining attention, with ferritin as a key biomarker. Hyperferritinemia probably contributes to insulin resistance and subsequently to decreased insulin secretion, causing the development of insulin resistance. The link between ferritin and insulin resistance (IR) varies based on ethnicity, gender, and glycemic state. Objectives: This study investigates serum ferritin levels in different glycemic stages and explores potential correlations between ferritin and insulin resistance markers (blood glucose, serum insulin, and HOMA-IR) Methods: The study was conducted at the Department of Biochemistry, Sir Salimullah Medical College, Dhaka, Bangladesh, from March 2018 to February 2019. A total of 140 subjects were included to conduct this study. Participants were categorized into three groups: those with normal fasting glucose (NFG group), impaired fasting glucose (IFG group), and newly diagnosed type 2 diabetes mellitus (Diabetic group) according to WHO (2006) criteria. A purposive convenient sampling method was used, focusing on adults aged 25 to 55 years. Exclusion criteria were applied to eliminate individuals with inflammatory diseases, chronic conditions, major cardiovascular events, anemia, or specific medications that could affect ferritin levels. Results: The study found that serum ferritin levels significantly differed among three glycemic groups (NFG, IFG, and T2DM) with higher levels in T2DM. IFG and T2DM groups also had elevated serum insulin and HOMA-IR. Serum ferritin correlated strongly with fasting blood glucose, serum insulin, HOMA-IR, and BMI. The highest tertile of ferritin levels were associated with the IFG &amp; diabetic group. Conclusion. Elevated serum ferritin levels in IFG and type 2 diabetes may significantly impact glucose regulation. Compared to NFG, there are high insulin resistance markers (fasting insulin, glucose, HOMA-IR) in T2DM and IFG. They have crucial implications for both therapy and prognosis in these conditions. Mugda Med Coll J. 2023; 6(2): 57-63

Clinical Studies on Diabetic and Non- Diabetic Patients with Respect to Lipid Profile Test

Introduction; Dyslipidemia is one of the major cardiovascular disease (CVD) risk factors and plays an important role in the progress of atherosclerosis. The prevalence of Dyslipidemia in type 2 diabetes is double with respect to the general population. These are more complex abnormalities that are caused by the interrelation among obesity, insulin resistance and hyper insulin. It is worth to emphasize that the fatty tissue is exclusively related to risk factors, such as the altered insulin and lipid profile, which can contribute to the development of the insulin resistance syndrome, which comprises several risk factors for the emergence of cardiovascular complications. In patients with type 2 diabetes, which is equivalent most commonly characterized by elevated TG and reduced HDL-C. These abnormalities can be present alone or in combination with other metabolic disorders. Material and Method : This project was conducted by the department of Biochemistry at Asian Diagnostic lab from two month period of time on 300 patients belongs Bangalore urban district (kalasipalya) were Selected. Blood glucose, lipid profile, kidney function and liver function estimation was done by Uv test of Enzymatic reference method. COBASc311 ANALYSE Roche/Hitachi Cobas c 311 analyzer is an automated software controlled system for clinical chemistry analysis both qualitative and quantitative analysis determination

Screening for Renal Function Impairment in Patients with Chronic Type II Diabetes Mellitus in a Tertiary Care Hospital of Pakistan

Objective: The objective of the present study was to detect early biochemical changes, in type II diabetics, indicating renal function impairment leading to Chronic Kidney Disease (CKD). Methodology: This study was conducted in the Department of Biochemistry at Shaikh Zayed FPGMI, Lahore during September 2016 to April 2017. It was a cross-sectional analytical study and was done through nonprobability convenient sampling The study comprised of 50 diagnosed patients of type II diabetes mellitus (for the last 10 years) and 50 healthy subjects. Both male and female participants in equal number between the age of 35-75 were included in the study. Blood glucose level (random), blood urea, serum creatinine, urinary albumin and urinary creatinine were estimated and albumin to creatinine ratio (ACR) in mg/g was calculated. eGFR was also calculated using S/creatinine. The lab values of the study parameters were recorded on the designed proforma after getting proper written consent from the participants. SPSS 20.0 was used for data entry and analysis. Results: Mean values of random plasma glucose level, blood urea, serum creatinine, urine albumin, urine creatinine, ACR and eGFR of patients when compared with those of healthy group showed significant p-values (≤0.05). Conclusion: There was a significant difference in renal laboratory parameters between diabetic patients and healthy controls indicating the presence of CKD. In a developing country like Pakistan type II diabetes mellitus is an incidental finding due to lack of regular health monitoring and it is very difficult to determine the exact duration of the disease. Patients of type II DM develop CKD (Chronic Kidney Disease) due to persistent high plasma glucose levels. Therefore good control of DM and regular monitoring of renal parameters will be helpful in preventing the development of CKD. Key Words: Diabetes Mellitus, Nephropathy, Chronic Kidney Disease, Urinary Albumin to Creatinine ratio.

TRNA: The operational RNA code and protein folding

tRNA: The operational RNA code and protein folding Charles W. Carter, Jr., from the Department of Biochemistry and Biophysics, University of North Carolina at Chapel Hill, relates molecular recognition used in genetic coding to structures of aminoacyl-tRNA synthetases and their cognate tRNAs. Genetic coding is simultaneously widely understood and little appreciated. Widely understood because Marshall Nierenberg worked out the codon assignments within a decade or so of the double helical structure of DNA by Watson and Crick (1). Little appreciated because a code, as far as we know, is something Nature had never produced – a symbolic mapping of the physical chemistry of the 20 amino acid side chains. The Morse code is a widely appreciated example. Like inheritance, the genetic code is a property of biology.

THYROID FUNCTION ABNORMALITIES IN PATIENTS WITH METABOLIC SYNDROME: AN OBSERVATIONAL STUDY

Objective: The objective of the study is to study the presence of thyroid function abnormalities in cases with metabolic syndrome. Methods: This was a prospective observational study done in the department of biochemistry of a tertiary care medical college. 60 patients fulfilling the criteria for metabolic syndrome as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria were included in this study. Demographic details of all the patients were noted. A detailed history was taken and thorough clinical examination was done. Thyroid function test was done in all cases. The presence of thyroid function test abnormalities was analyzed. Statistical analysis was done using SSPS 21.0 software and p&lt;0.05 was taken as statistically significant. Results: Out of these 60 cases, there were 37 (61.67%) males and 23 (38.33%) females with a M: F ratio of 1:0.62. The mean age of male and female patients was found to be 47.96±14.78 and 45.78±13.26 years, respectively. The mean age of male and female patients was found to be comparable with no statistically significant difference. Skin changes were present in 23 (38.33%) cases followed by tiredness (36.67%), constipation (25.00%), weight gain (21.67%), and pallor (15%). 29 (48.33%) were euthyroid whereas subclinical and clinical hypothyroidism was present in 18 (30%) and 10 (16.67%), respectively. 3 (5%) patients were found to have subclinical hyperthyroidism whereas there was no patient with clinical hyperthyroidism. Conclusion: Thyroid function abnormalities are common in patients with metabolic syndrome. It is therefore important to screen patients for thyroid function abnormalities so that appropriate interventions can be undertaken if necessary.

Correlation Between HbA1c, Serum Magnesium (Mg) and Lipid Profile in Type 2 Diabetic Foot Ulcer and without Foot Ulcer Patients – A Cross-Sectional Study

Introduction : Diabetes mellitus, especially Type 2, is a common metabolic problem in Bangladesh with serious complications like diabetic foot ulcer. The relationship between HbA1c, serum magnesium, and lipid profile in type 2 DFU patients was examined in this study. Aim of the study: The aim of this study was to examine the correlation between HbA1c, serum Magnesium, and lipid profile in type 2 diabetic foot ulcer and without foot ulcer patients. Methods: This cross-sectional study was conducted in the Department of Biochemistry and Molecular Biology, BIRDEM Academy, Dhaka, Bangladesh during the period from January 2018 to December 2018 Result: In total 120 respondents who were adult male and female were included in the study. In our study, we found that the majority of our patients (58.3%) were aged between 41-50 yrs. in group II. We found the percentage of male and female participants were 66.7% and 33.3% in group I and 51.7% and 48.3% in group II respectively. The negative correlation was found between serum magnesium with fasting plasma glucose and Triacylglycerol in group I. The significant positive correlation was found between serum Mg and HDL-c (r=0.443; p&lt;0.01) in group I. Conclusion: Diabetes Mellitus, notably Type 2, poses challenges in Bangladesh, including Diabetic Foot Ulcer (DFU). This study explores links between HbA1c, serum magnesium, and lipid profile in Type 2 DFU patients, potentially guiding early interventions and improving diabetic care outcomes. Bangladesh Heart Journal 2024; 39(1): 24-30

Association of Serum Uric Acid and Liver Enzymes in Adults at Tertiary Level Hospital in Bangladesh

The level of serum uric acid (SUA) has been linked to metabolic syndrome, diabetes, and cardiovascular disease. The purpose of this study was to evaluate the relationship between SUA and serum liver enzymes in a Bangladeshi adult population. This cross-sectional study was conducted among apparently healthy adults aged &gt;18 years, from March 2019 to February 2020 at the Department of Biochemistry, Sir Salimullah Medical College (SSMC), Dhaka. SUA, liver enzymes, lipid profile and other biochemical markers were measured in the collected samples by using standard methods. All statistical analyses were performed by using SPSS version 22.0 software and p&lt;0.05 was considered statistically significant. A total of 140 subjects were selected and blood sample were collected for biochemical analysis. Among them 70 were male and 70 were female. Serum uric acid (SUA), Alanine transaminase (ALT), Aspartate aminotransferase (AST) and Gamma-glutamyl transferase (GGT) levels were significantly (p&lt;0.001) higher in male than female group. Pearson’s correlation analysis showed that there were significant positive correlation between SUA and serum ALT, AST, GGT (p&lt;0.001). However, it also showed significant positive correlation between SUA and total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), while negative correlation was found between SUA and high density lipoprotein cholesterol (HDL-C) (p&lt;0.001). The role of SUA in the prediction of elevated liver enzymes showed area under the ROC Curve (AUC) 0.839 for ALT, 0.848 for AST and 0.809 for GGT respectively. SUA is positively related with ALT, AST, GGT in adults. More prospective studies are needed to clarify the complex relationship between SUA and liver enzymes in the general population. Bangladesh Med J. 2022 Sept; 51(3): 18-27

A Study Estimating the Serum TSH Levels in First Trimester Pregnant Women

Background Pregnancy is a physiological condition among women. Pregnancy brings about major changes in the hormonal levels. Thyroid stimulating hormone is a hormone produced by anterior pituitary. TSH provides the most common sensitive index to reliably detect thyroid function abnormalities.ObjectiveThe goal of this study was to estimate the levels of serum TSH at first trimester in pregnant women in the department of Biochemistry St. Johnrsquos Medical College amp Hospital and compare with the biological reference intervals as established in the laboratory. Methodology This retrospective study was conducted from January to December 2021 in the department of Biochemistry St. Johnrsquos Medical College amp Hospital. Lab data review of pregnant women has been analysed for serum TSH. The study included 228 pregnant women in their first trimester aged between 20 and 35 years. Serum TSH levels were measured using the ABBOTT ARCHITECT CI8200 through Chemiluminometric Immunoassay. The collected data underwent analysis and comparison to derive descriptive statistics.Result A total of 228 pregnant women in the first trimester fulfilling the inclusion criteria were included. Maternal age of the study population was 20-35 years. Among the pregnant women 12 5.3 women showed low values for TSH lt0.35 microIUMl 11 4.8 women showed higher values for TSH gt4.94 microIUmL and 205 89.9 showed normal TSH levels during first trimester. In this study the mean TSH level in pregnant women was found to be 1.94plusmn1.50 microIUmL. The median TSH levels was 1.51 microIUmL 2.5th and 97.5th percentiles P2.5-P97.5 0.23-5.86 microIUmL.Conclusion The observed connection between aberrant TSH serum levels during the first trimester and adverse pregnancy outcomes underscores the necessity for proactive screening. Identifying pregnant women with elevated or reduced TSH levels early on holds significant potential for preventing complications. The incorporation of such screening protocols can yield a range of benefits including timely interventions and enhanced management strategies to mitigate adverse outcomes. Our research contributes to the growing body of evidence supporting TSH screening during early pregnancy emphasizing its pivotal role in safeguarding maternal and foetal health.

A Prospective Interventional Study on Modified One-minute Preceptor Model: An Effective Teaching-learning Tool for Early Clinical Exposure in Biochemistry

Introduction: Early Clinical Exposure (ECE) was incorporated into the Competency-based Medical Education (CBME) curriculum in 2019. ECE in a classroom setting is conducted through Clinical Case Discussion (CCD) using paper-based clinical case scenarios. The assessment pattern of CBME and Maharashtra University of Health Sciences (MUHS) includes clinical case-based questions. Therefore, assessing and developing clinical reasoning skills and critical thinking has become the need of the hour. Aim: To measure the effectiveness of the modified One-minute Preceptor (OMP) model as a teaching-learning tool for CCD to enhance the knowledge and reasoning skills of Phase I Bachelor of Medicine Bachelor of Surgery (MBBS) students and to assess the perception of students and faculty towards the modified OMP model. Materials and Methods: This prospective interventional study was conducted in the Department of Biochemistry at Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India from February 2020 to May 2020. Out of 250 Phase I MBBS students, 180 who had given consent and participated in all the sessions were included. Eight faculty members voluntarily participated in the study. The faculty involved in CCD for the control and study groups were different and selected through randomisation. After a didactic lecture, a pretest was administered, and then students were divided into Control group A (n=90) and Study group B (n=90). For CCD, the modified OMP model was used for the study group and the traditional unstructured method for the control group. A post-test was given after CCD, and feedback was collected from faculty and students. Quantitative analysis of the feedback was done using a 5-point Likert scale, and open-ended questions were qualitatively assessed. Pretest and post-test scores were analysed using an unpaired t-test. Learning gain was measured, and program evaluation was conducted using Kirkpatrick’s model. Results: There was a statistically significant difference in the post-test scores obtained by the control group and study group (p-value &lt;0.001). A higher normalised learning gain (0.83) was observed in the study group. The modified OMP model was perceived as an effective, interactive teaching-learning tool for CCD by both students and faculty. Conclusion: CCD using the modified OMP model significantly improved knowledge, critical thinking, and reasoning skills of students. Even after modifications to the original OMP model, the effectiveness of this model for preclinical subjects remains unaffected.

Association of Serum Hydrogen Sulphide Levels and Dyslipidaemia: A Cross-sectional Study

Introduction: Dyslipidaemia is an important risk factor for coronary artery disease. Oxidative damage to plasma lipoproteins ultimately results in the development of atherosclerosis. Since Hydrogen Sulphide (H2 S) is a cytoprotective molecule in oxidative stress, decreased H2 S levels may be a cause of dyslipidaemia. Aim: To determine the relationship between the serum levels of H2 S with serum Triglycerides (TG), Total Cholesterol (TC), and High-density Lipoprotein Cholesterol (HDL-C) in cases of dyslipidaemia. Materials and Methods: A cross-sectional study was conducted between December 2022 and June 2023 in the Departments of Biochemistry and Medicine at KPC Medical College, Jadavpur, Kolkata, West Bengal, India. Serum lipid profile {TC, TGs, HDL-C, and Low-density Lipoprotein Cholesterol (LDL-C) (calculated by Friedewald’s equation)} and serum H2 S were measured in 70 cases of dyslipidaemia {according to National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria} aged between 30 to 80 years and compared with an equal number of healthy volunteers as controls. The means of continuous variables were compared by independent t-tests and Mann-Whitney U tests. The Chi-square test was applied to compare gender distribution. Pearson’s and Spearman’s correlation coefficients were calculated for normal and non normal distributions, respectively. Results: The mean age of dyslipidaemic patients (54.54 years±11.19) was significantly (p=0.0017) higher than that of the controls (47.02 years±16.18). Among the 70 cases of dyslipidaemia, 38 participants were male and 32 were female, while among the healthy controls (n=70), 42 participants were male and 28 were female. The serum H2 S levels in cases of dyslipidaemia (37.91±6.28 μmol/L) were significantly lower than in the healthy controls (58.52±12.92, p&lt;0.01 μmol/L). A significant positive correlation was found between serum H2 S levels and HDL-cholesterol (r=0.81, p&lt;0.001), whereas a negative correlation was found between serum H2 S and TG levels (r=-0.55, p&lt;0.001). Conclusion: In the present study, dyslipidaemia was associated with decreased levels of serum H2 S. Serum H2 S was positively correlated with serum HDL and negatively correlated with serum TG levels.

Comparison of Liquid Sodium Heparin Syringe and Preheparinised Syringe for Sample Rejection in Arterial Blood Gas Analysis: A Cross-sectional Study

Introduction: In hospital settings, Arterial Blood Gas (ABG) analysis is a routine investigation. Many errors can arise in the process, with 70% of errors in ABG analysis occurring during the preanalytical phase. Liquid heparin is commonly used as an anticoagulant in sample collection devices for Blood Gas (BG) analysis; however, inadequate heparin concentration and improper mixing of blood samples after collection often lead to incorrect results. This can be prevented by using syringes preloaded with lyophilised heparin. Aim: To monitor the prevalence of sample rejection collected by the device using liquid sodium heparin and calcium-balanced dried lithium heparin. Materials and Methods: This cross-sectional study was conducted at the ABG laboratory, Department of Biochemistry, Amrita Institute of Medical Sciences and Research Centre, Amrita Viswavidyapeetham University, Kochi, Kerala, India over a 4-month period from December 2022 to March 2023. ABG samples collected using either of the techniques were included, while venous BG samples were excluded. The sample size was 10,957 for each of the two groups- Group A and Group B. Group A included samples collected using liquid sodium heparin, and group B included spray-dried, calcium-balanced lithium heparin from different departments. The incidence of blood clots, air bubbles, and inadequate volume was studied. For all categorical variables, the results were expressed as the frequency and percentage of errors. An unpaired t-test (two-tailed) was used for data analysis. Results: In comparison with liquid sodium heparin collection, errors in the quality of the specimen such as blood clots (1.7% to 1.1%), air bubbles (0.04% to 0%), and inadequate volume (0.2% to 0.03%) were significantly reduced (p-value=0.002) with spray-dried, calcium-balanced lithium heparin (BD Preset™ Safety BG Syringe). Conclusion: The present study found that using calcium- balanced lithium heparin syringes over manually flushed liquid sodium heparin syringes reduces the risk of clots, thus preventing equipment malfunction and maintenance costs. With the introduction of preset syringes, the chance of air bubbles and insufficient volume can also be overcomed.

Correlation of Serum Plasminogen Activator Inhibitor-1 with Body Mass Index and Blood Pressure among Newly Diagnosed Primary Hypertensive Patients: A Cross-sectional Study

Introduction: Plasminogen Activator Inhibitor-1 (PAI-1), a serine protease inhibitor expressed in adipose tissue, causes inflammation in hypertension and vice versa. The excess adipose tissue increases the production of PAI-1. There have been no relevant studies conducted on PAI-1 in southern Odisha in relation to Body Mass Index (BMI) and hypertension. Aim: To compare the BMI, Waist Hip Ratio (WHR), Waist Circumference (WC), and serum levels of PAI-1 in hypertensive cases with controls, and also to correlate the serum level of PAI-1 with BMI and blood pressure. Materials and Methods: This cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Medicine of MKCG Medical College and Hospital, Berhampur, Odisha, India from November 2020 to August 2021. A total of 45 newly diagnosed primary hypertensive patients and 43 healthy age and sex-matched individuals between the ages of 18 to 60 years were enrolled in the study. Serum PAI-1 was measured by Enzyme-Linked Immunosorbent Assay (ELISA). BMI, WC, hip circumference, WHR, and blood pressures of the controls as well as cases were recorded. Data were statistically analysed using the Student’s t-test and Pearson’s correlation coefficient. Results: The proportion of males was higher (56%) than females (44%). The cases had a significantly higher level of serum PAI-1 (203.36 ng/mL) compared to the control group (60.11 ng/mL) (p-value&lt;0.001). The cases had a higher BMI, WC (meters), and WHR compared to the control group. The serum PAI-1 level positively correlated with Systolic Blood Pressure (SBP) (r-value=0.852, p-value&lt;0.001), Diastolic Blood Pressure (DBP) (r-value=0.726, p-value=0.000), BMI (r-value=0.620, p-value=0.001), WC (r-value=0.444, p-value=0.002), and WHR (r-value=0.593, p-value&lt;0.001). Conclusion: A high serum PAI-1 level was found in the newly diagnosed hypertensive cases, and a significant positive correlation was observed between PAI-1 and systolic and diastolic blood pressure, along with BMI, WC, and WHR.