Dipstick Method Research Articles

Integrating filter paper extraction, isothermal amplification, and lateral flow dipstick methods to detect Streptococcus agalactiae in milk within 15 min.

Mastitis is one of the most serious diseases affecting dairy farming, causing huge economic losses worldwide. Streptococcus agalactiae is the main pathogenic bacterium of contagious mastitis and can deliver a devastating blow to a farm's economy. Rapid detection is the key to disease control. In this study, a rapid detection method for S. agalactiae was established. This method combines filter paper extraction, multienzyme isothermal rapid amplification (MIRA), and lateral flow dipsticks (LFD). To simplify the extraction procedure, we designed a disposable extraction device (DED). First, DED performance was evaluated by polymerase chain reaction (PCR) and then the lysis formula and extraction time were optimized. Second, this study compared the extraction performance of a filter paper and an automatic nucleic acid extraction instrument. After screening primers, MIRA for S. agalactiae was established and combined with LFD. Specificity and sensitivity were evaluated after optimizing the reaction conditions. The results showed that the lowest extraction line for DED was 0.01-0.001 ng/μl. In the specificity study, 12 different bacteria were tested, and only S. agalactiae was found to be positive. In the sensitivity study, seven dilution gradients were established, and the lowest detection line was 3.52 × 102 CFU/ml. In summary, the method established in this study does not require laboratory equipment and is suitable for on-site detection. The entire method takes only 15 min, is low in cost, has high precision and low technical requirements for operators, which is in contrast with the high cost and cumbersome operation of traditional methods, and is suitable for on-site testing in areas with limited facilities.

Comparison of the Urine Protein Examination Results Using the Dipstick Method and The Ewitz Method at Kabila Health Center

This study aims to determine the differences in the results of urine protein examination in pregnant women using the dipstick method and the ewitz method at the Kabila Health Center, Bone Bolango district. The method used in this research is analytic observational by looking for the relationship between variables through an analysis of the data from observations in the laboratory or through observation of the analytical process. From the results of the study of 28 samples of pregnant women, it was found that there was no significant difference from the comparison of the results of urine protein examination using the dipstick method and the Ewitz method, where the p value was 1,000.

Study on correlation of urine specific gravity with other laboratory parameters of urine in children with Nephrotic syndrome

Nephrotic syndrome is a frequent childhood kidney disease in which proteinuria is a significant characteristic. Proteinuria can be a benign condition as well as indicates severe underlying renal or systemic diseases. The variation in the prevalence of proteinuria may occur based on the definition used or the evaluation time of the test. Proteinuria is present in up to 10% of routine urine testing in school-aged children, although this decreases to 0.1% with repeated testing. The study aimed to analyze the correlation of urinary specific gravity with other laboratory parameters of urine in children with nephrotic syndrome. Methods: This cross-sectional study was conducted in the Department of Pediatric Nephrology (NIKDU), Dhaka from October 2019 to June 2021, and a total of 153 patients with nephrotic syndrome were enrolled after taking written consent. Urine samples were collected for both 24 hours and spot for estimation of urinary protein, urinary creatinine, dipstick protein, and specific gravity by dipstick method. Spot urinary Protein Creatinine Ratio (PCR) and 24 hours urinary protein were also estimated. Results: Among 153 study subjects maximum (44.4%) were 2-5 years old followed by 58 (37.9%) who were 5-10 years and 27 (17.6%) were >10 years old. Boys (61.4%) were more predominant than girls (38.6%). Mean 24 hours urinary volume was 1097.78±662.63 ml, 24 hours urinary creatinine was 32.17±23.70 mg/dl, 24 hours urinary total protein was 851.42±123.68 mg/dl, 24 hours urinary total protein (UTP) was 7.52±7.65 gm/m2/24 hours urinary specific gravity 1.020±0.02, spot urinary protein 989.49±1136.73 mg/dl, spot urinary creatinine was46.09±43.73 mg/dl, spot urinary PCR was 21.87±18.24 mg/mg and spot urinary specific gravity was 1.020±0.01. The Scatter diagram showed a significant positive correlation of 24 hours urinary specific gravity with 24 hours urinary protein (r=0.169, p=0.037). There was a significant positive correlation of 24 hours specific gravity with 24 hours urinary creatinine (r=0.380, p=<0.001). There was a significant positive correlation of spot urinary protein with spot urinary specific gravity as well (r=0.206, p=0.011). Spot urinary specific gravity showed a significant positive correlation with spot urinary creatinine (r=0.355, p=<0.001). There was a significant negative correlation of spot urinary specific gravity with spot urinary PCR (r= -305, p=<0.001). Conclusion: It can be concluded that urinary specific gravity had a substantial correlation with other laboratory parameters of urine and can be used as an important diagnostic tool for diagnosing proteinuria in children with nephrotic syndrome

A phthalimide-based turn on fluorosensor for selective and rapid detection of G-series nerve agent’s mimics

Organophosphorus-based nerve agents are extremely toxic. Their use in terrorist attacks and wars has caused increased interest in developing simple, portable, displayable, and authentic methods for detecting these lethal substances. In this article, we have designed and synthesized a fluorosenor (HBAI) derived from 4-aminophthalimide moiety that exhibits high selectivity and sensitivity towards G-series nerve agent mimics in their solution and gas phases, respectively. HBAI shows significant fluorescence response to DCP and DCNP that induced noticeable bare eye color changes under a 365 nm UV light irradiation. The detection limit of HBAI for DCP and DCNP has been established in the order of 10-7 M and 10-6 M, respectively. The sensing mechanism for the probe HBAI has been elucidated by time-resolved photoluminescence decay analysis and 1H NMR titration experiment. The significant photoluminescence enhancement is mainly found for disrupting the excited state intramolecular proton transfer (ESIPT) mechanism because of the phosphorylation process. However, for the practical utility of HBAI, a test kit employing Whatman-41 filter paper has been fabricated as a portable and displayable photonic device for on-site detection of G-series nerve agents. Also, a dip-stick method has been demonstrated to identify the vapor of G-series nerve agents mimic.

Research Note: Application of reverse-transcription recombinase-aided amplification-lateral flow dipstick method in the detection of infectious bursal disease virus

Infectious bursal disease (IBD) is a highly contagious viral disease caused by infectious bursal disease virus (IBDV) in chickens. The consequent immunosuppression and secondary infection affect the healthy development of chicken industry. In this study, specific primers and probes were screened in the conserved region of IBDV VP2 gene sequence, and reverse transcription-recombinase-aided amplification (RT-RAA) was combined with lateral flow dipstick (LFD) for establishing RT-RAA-LFD method for detection of IBDV in chickens. The reaction conditions of RT-RAA-LFD assay were optimized, and the specificity, sensitivity, and repeatability were verified. The results showed that the RT-RAA-LFD method could amplify the IBDV target fragment at 37°C for 15 min, and the required primer and probe concentration was 1,250 nmol/L. The detection results were directly observed by the dipstick, the lowest detectable limit (LDL) for IBDV was 10 copies/μL, and there was no cross reaction with several common immunosuppressive pathogens in poultry. The total coincidence rate of sample test results between RT-RAA-LFD and reverse transcription-polymerase chain reaction (RT-PCR) was 95.83%. Due to advantages of high sensitivity, strong specificity, easy operation, fast detection, the established RT-RAA-LFD method can provide some technical support and new solutions for local laboratory to detect IBDV.

A URINE GLUCOSE LEVELS AND URINE SPECIFIC GRAVITY IN TYPE 2 DIABETES MELLITUS PATIENTS IN BUDHI ASIH HOSPITAL

Background: Diabetes mellitus is caused by the pancreas not being able to produce the insulin hormone that regulates glucose in the body, resulting in hyperglycemia which is associated with long-term damage, dysfunction, failure of various organs (eyes, kidneys, nerves, heart, and blood vessels). Diabetes is included as a non-communicable disease but has a priority for follow-up because the number of cases and its prevalence has continued to increase over the last few decades. Examination of diabetes mellitus can be done with blood samples and urine samples. Examination of diabetes mellitus with urine samples was carried out using the dipstick method to determine the parameters of urine glucose and urine specific gravity. Objective: To determine the correlation of urine glucose and urine specific gravity in patients with type 2 diabetes mellitus. Methods: Correlative analytic study with a cross-sectional approach. This study was conducted in January-September 2021 with samples of type 2 diabetes mellitus patients who examined urine glucose and urine specific gravity with the dipstick method. Results: The results of the correlation test of urine glucose and urine specific gravity in patients with type 2 diabetes mellitus are 0.065 (> 0.05) which means that there is no correlation between urine glucose and urine specific gravity in patients with type 2 diabetes mellitus. The results of the correlation coefficient of urine glucose and specific gravity urine in patients with type 2 diabetes mellitus is 0.189 which is included in the range of weak correlation coefficients. Conclusion: Based on these results, it can be concluded that there is no significant correlation between urine glucose and urine specific gravity in patients with type 2 diabetes mellitus.

Quick detection of Carassius auratus herpesvirus (CaHV) by recombinase-aid amplification lateral flow dipstick (RAA-LFD) method.

Crucian carp (Carassius auratus) is one of the major freshwater species and is also a common food fish in China. Recently, Carassius auratus herpesvirus (CaHV) could induce fatal viral disease with high mortality of crucian carp, which had caused huge economic losses. In this study, we described a rapid and simple recombinase-aid amplification (RAA) assay coupled with lateral flow dipstick (LFD), which could achieve sensitive diagnosis of tumor necrosis factor receptor (TNFR) of CaHV within 35 min at 40°C. Our RAA-LFD method had a satisfactory detection limit of 100 gene copies per reaction, which was 100-fold more sensitive than traditional PCR. In addition, no cross-reaction was observed with other viral pathogens, including koi herpesvirus (KHV), cyprinid herpesvirus 2 (CyHV-2), infectious hematopoietic necrosis virus (IHNV), spring viremia of carp virus (SVCV) and grass carp reovirus (GCRV). Furthermore, the overall cost of the method was cut in half compared to previous studies. In conclusion, RAA-LFD assay is therefore, a promising alternative for point-of-care testing (POCT) of CaHV, which is feasible and of certain value in application of aquatic disease control.

Pengaruh Variasi Masa Pengobatan Obat Anti Tuberkulosis (OAT) terhadap Billirubin dalam Urine Penderita Tuberkulosis Metode Carik Celup

Treatment of Tuberculosis using Anti Tuberculosis Drugs (OAT) has a hepatotoxic effect that can cause liver function disorders, one of which is bilirubin. Examination of bilirubin can use blood and urine. Qualitative and semi-quantitative examination of bilirubin in urine by diazo reaction using the dipstick or dipstick method is widely used because it is fast, more practical, and more sensitive. The purpose of this study was to determine the effect of variations in the treatment period of Anti Tuberculosis Drugs (OAT) on bilirubin in the urine of tuberculosis patients. This research is an analytical observational research. The sample in this study amounted to 20 people in the initial and follow-up treatment periods. Urine samples in patients with tuberculosis were examined for urine bilirubin levels using the dipstick method. The results showed that the level of bilirubin in the urine qualitatively in the early stages of treatment had a positive value, namely 5 out of 9 tuberculosis patients (56%) with a positive level of 1 (+1) semi-quantitatively. The level of bilirubin in the urine qualitatively in the advanced stage of treatment has a positive value, namely 1 out of 11 tuberculosis patients (9%) with a positive level of 1 (+1) semi-quantitatively. The results of the Chi-Square bilirubin test in urine qualitatively and semi-quantitatively showed the value of p = 0.024 < = 0.05. The conclusion is that variations in the treatment period of Anti Tuberculosis Drugs (OAT) have an effect on bilirubin in the urine of tuberculosis patients.

A Tertiary Care Hospital's Observations on the Prevalence and Antibiotic Sensitivity of the Most Common Organisms Causing Urinary Tract Infections in Children

Objective: The purpose of this research was to evaluate the antibiotic resistance profile of urinary tract infection-causing bacteria and their prevalence among children presenting to a tertiary care hospital. Study Design: Cross-sectional/ Descriptive study Place and Duration: This study was carried out at Khyber Teaching Hospital, Peshawar from June, 2021 to May 2022. Methods: Total 112 suspected cases (children) of UTI with ages 6-months to 14 years were presented. After receiving parental agreement, we documented the children's age, gender, residence, and parental education level.It was decided to perform a urine dipstick test to check for nitrites and leucocytes, and then analyze the leucocytes and bacteria under the microscope. Antimicrobial resistance was tested using the modified Kirby-Bauer disc diffusion technique with a panel of antimicrobials.SPSS 20.0 was used to analyze all data. Results: Among 112 included cases, 58 (51.8%) were males and the rest were 54 (48.2%) female children. Frequency of leucocytes and nitrites by urine dipstick method was 30 (26.8%) and 12 (10%) but under the microscope, number of leucocytes were 15 (13.4%) and bacteria was 9 (8.03%). There were 65 (58.04%) gram positive and majority were females and 47 (41.96%) were gram negative cases. We found E.coli was the most prevalent microorganism found in 46 (70.8%) cases, 5 (7.7%) Klebsiella spp. and Pseudomonas spp. was 4 (6.2%). We found that microorganism were highly resistant (100%) to antibiotics ceftazidime, cefoperazone, ampicillin and ofloxacin while ciprofloxacin, cefuroxime and ceftriaxone showed high sensitivity. Conclusion: We observed that E.coli was the most frequent bacteria in UTI urine samples. Antimicrobial resistance in UTI-causing pathogens is worrying. It's crucial to monitor UTI-causing microbes' antibiotic susceptibility trends. Keywords:UTI, E.coli, Klebsiella spp., Resistance, Sensitivity

Level of Uric Acid in Women Suffering from Pre-Eclampsia and its Comparison with Normal Pregnancy

Objective: Current study is conducted to explore the variations in uric acid level in pre-eclamptic and normal healthy pregnancy in its third trimester in pregnant females. Methods: This descriptive cross sectional study was conducted to measure the serum uric acid level in mg/dl by kit method. The cutoff value was kept at 5mg/dl. The 10 ml of midstream urine was collected for estimation of urinary protein by dipstick method and graded from +1 to +3. For comparison between two groups in terms of levels of uric acid, independent sample t-test was used. Pearson Chi Square test was used to compare qualitative variables. Results: Raised levels of uric acid were obtained in 81.6% preeclampsia samples, and 13.1% found among normal samples, p<0.01 showed that level of serum uric acid has a significant relationship with preeclampsia. Independent sample t-test showed a significant mean difference for SBP, DBP, and SUA between two groups, (p<0.01) Conclusion: Significant high level of serum uric acid level was found in pre-eclamptic females than normotensive women. The findings suggest that measurement of serum uric acid may be a suitable marker in diagnosis of pre-eclampsia. Keywords: Pregnancy, Pre-eclampsia, Serum Uric Acid, Hypertension

Evaluation of Heller's reaction and the urine dipstick method alone or in combination to detect proteinuria in sheep

Urine dipstick and Heller's reaction are easy first-line screening tests for the detection of proteinuria; however, the performance of these methods in alkaline ovine urine is largely unknown. The aim of this study was to evaluate the diagnostic performance of Heller's reaction alone or in combination with dipstick for the detection of proteinuria in sheep, using the urine protein to creatinine ratio (UP/C) with two cut-off values as the reference method. Ninety-eight urine samples were collected from sheep using the transient apnea method. Heller's reaction, the dipstick method, and the UP/C ratio were used to assess proteinuria. The results were statistically analyzed twice, based on two different UP/C cut-off values of 0.2 and 0.5. Cohen's kappa value was used to determine the agreement between the UP/C ratios and Heller's reaction, the dipstick method, or the combination of methods. Sensitivity, specificity, and positive and negative likelihood ratios were calculated. ROC curves were also generated, and the areas under the curve (AUC) were evaluated to determine the optimal threshold for the numerical values of the two methods. Heller's reaction is more specific (96.67% and 96.00% when the cut-off value is 0.2 and 0.5, respectively) than the dipstick method, while the dipstick method was more sensitive (91.18% and 91.30%, when the cut-off value was 0.2 and 0.5, respectively) than Heller's reaction for the detection of proteinuria. Both tests were accurate when any grade >0 was considered positive. Proteinuria can almost be excluded in ovine urine samples with negative Heller's reaction and dipstick test.

Proteinuria in Asymptomatic Siblings of Children with Steroid Resistant Nephrotic Syndrome: A Screening Using Urinary Dipstick.

To screen asymptomatic siblings of steroid-resistant nephrotic syndrome patients for proteinuria using the urinary dipstick method to determine the involvement of siblings in the familial and likely genetic cause of the steroid-resistant nephrotic syndrome. This cross-sectional study was performed at the outpatient department of Sindh Institute of Urology and Transplantation (SIUT) from May to July 2021. Out of 104 patients with steroid-resistant nephrotic syndrome, siblings of 66 patients were enrolled. Mean age of primary patients with steroid resistant nephrotic syndrome was 8.7±4.3 years. Most common histopathological diagnosis was focal segmental glomerulosclerosis in 25 (37.9%) children followed by minimal change disease in 17(25.8%) of them. The majority, 48 (72.7%) patients were on immunosuppressive treatment, while 4 (6.1%) had progressed to chronic kidney disease (CKD). A total of 178 siblings were recruited in the study. There were 99(55.6%) boys and 79(44.4%) girls. Their mean age was 10.67±6.2 years. Consanguinity was high in our study population i.e. 56(84%) families. Positive proteinuria on dipstick was detected in only 5(7.5%) enrolled SRNS families. One family refused further testing. Two of the five affected siblings had nephrotic range proteinuria. Renal biopsy of one of them showed membranous nephropathy while the second showed mesangiocapillary glomerulonephritis. Both had normal renal functions. The frequency of proteinuria in asymptomatic siblings of children with steroid-resistant syndrome is low in our population despite a high prevalence of consanguineous marriages. Hence, familial involvement of nephrotic syndrome is low and further genetic testing for monogenic causes is required in steroid-resistant nephrotic syndrome cases.

Role of Dipstick (Leucocyte Esterase Reagent Strips) in the Rapid Bedside Diagnosis of Spontaneous Bacterial Peritonitis

Objectives: To evaluate the dipstick in the rapid bedside diagnosis of spontaneous bacterial peritonitis (SBP) and avoid delay in initiation of antibiotic therapy and evaluate the prevalence of SBP by a conventional method. Methods: A prospective analysis was done on inpatients and OPD patients with cirrhotic ascites at Jaipur Golden Hospital Delhi, India. The study included 110 consecutive patients with cirrhotic ascites. The patients were divided into 2 groups those with the polymorph nuclear leucocytes (PMNs) >250/mm3 on cell count (positive result) and those with PMNs <250/mm3 (Negative results) and were then compared to the dipstick results. The results were used to find the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the rapid dipstick method for the diagnosis of SBP. In addition, the data was used to calculate the prevalence of SBP in our hospital. Results: A total number of 110 patients with cirrhotic ascites were studied who were presented to the Jaipur Golden Hospital, New Delhi, India with the complaint of abdominal distension. A total of 20 patients were diagnosed with SBP by the manual cell count method which is considered a gold standard for the diagnosis of SBP, and 90 patients were diagnosed as non-SBP. We re-diagnosed these 20 patients with SBP with a dipstick method, the dipstick method showed a positive result for 18 patients (90%) and a negative result for 2 patients (10%). Conclusion: In the SBP group, the dipstick showed 18 true positives and 2 false negatives. In the non-SBP group of 90 patients, the dipstick method showed negative results in all the patients with no positive results. Thus, the dipstick showed 100% true negatives with 0% false positives. The prevalence of SBP in patients with cirrhotic ascites in a hospital was found at 18.2%.

IDF21-0222 Prevalence and clinical predictors of Non-diabetic kidney disease in Type 2 Diabetes with renal involvement

Background: Renal Involvement in individuals with Type-2 Diabetes (T2DM) may be due to diabetes per se i.e., Diabetes kidney disease (DKD) or to other cause other than T2DM i.e., non-Diabetic kidney disease (NDKD) and in a group of individuals may have both (DKD+NDKD). Differentiation between the same is only possible with renal biopsy. Specific treatment options are available for NDKD which could potentially change outcomes. Data regarding the proportion of subtypes of renal involvement in diabetes is limited and flawed due to biases in performing renal biopsy. Most previous studies of renal biopsies are retrospective in nature. With increasing burden of T2DM worldwide it is imperative that we to establish non-invasive markers which could help to identify those who might benefit from renal biopsy to establish diagnosis of NDKD. Aim: To determine proportion of patients with T2D with renal involvement who have DKD, NDKD or mixed disease. To identify possible clinical predictor/s which could help decision making for targeted renal biopsy to identify those with NDKD component (NDKD and mixed group). Method: We recruited consecutive patient with renal involvement (eGFR >30ml/min/m2 and/or urinary albumin: creatinine excretion >/=300mg/g. Clinical history, demography of patients, Lipid profile, Liver function test, electrolytes, serum creatinine, urea, Albumin, globulin, Uric acid, 24hr urinary protein (by autoanalyzer), Glycated hemoglobin (HbA1C) Complete blood count (CBC) (automated hematology analyzer), Urine RE/ME (dipstick method), retinopathy (Digital fundus camera) and neuropathy (VPT) were documented. Histopathological classification of renal biopsy sample was undertaken as per International Society of Nephrology and the Renal Pathology Society classification. Results: Total 110 were included of whom 31% were female. 73 patients (66.4%) had DKD 20 patients (18.2%) had NDKD and in 17 patients (15.4%) had an overlap (Mixed group). Amongst NDKD IgA nephropathy was commonest cause of NDKD (25%). Duration of diabetes (p<0.001), late age of onset (p=0.03), BMI (p=0.02), presence of hematuria (p=0.04), retinopathy (p=0.003) and neuropathy(p=0.002) were present in different proportions in the DKD vs the other two groups combined. Multivariable regression analysis however showed that only duration of diabetes was able to discriminate DKD from the other two groups. (AOR=0.9, CI 0.945 0.996, P=0.02), but it had sensitivity of 54% and specificity of 81% (AUC 0.765, P <0.001). Discussion: Almost 25% of our patients with T2DM had some evidence of NDKD (either pure NDKD or mixed) and warrants biopsy for appropriate diagnosis and management. Amongst currently used discriminators, only duration of diabetes was able to predict (not very robust) which patients needed biopsy to identify NDKD.

Comparing Finger-stick Βeta-hydroxybutyrate with Dipstick Urine Tests in the Detection of Ketone Bodies in the Diagnosis of Children with Diabetic Ketoacidosis.

To compare the finger-stick β-hydroxybutyrate (β-OHB) method accuracy with dipstick urine test for the detection of ketone bodies to diagnose diabetic ketoacidosis in children. Cross-sectional study. Department of Pediatrics, National Institute of Child Health, Karachi, from March to August 2021. Ninety-six known or newly diagnosed diabetic patients aged 2-15 years with suboptimal glycemic control and diabetic ketoacidosis were included in the study. A urine dipstick test was utilised to evaluate the absence or presence of ketones in the urine. In point-of-care, blood β-OHB levels were recorded. Among 96 children, with median age of 10 years (IQR=6-11), 11 (11.5%) children had traces of urine ketones, 7 (7.3%) had + urine ketones, 19 (19.8%) had ++ urine ketones, 26 (27.1%) had +++ ketones and 19 (19.8%) had ++++ ketones. In 66 patients (68.75%), capillary blood ketone was observed to be positive by a finger-stick β-OHB method. The finger-stick β-OHB method had a higher sensitivity (90.4% vs. 84.9%), specificity (100% vs. 91.3%), and accuracy (92.7% vs. 86.5%) than the dipstick urine test. Finger-stick β-OHB method can serve as a more accurate alternative to the urinary dipstick method for the measurement of ketones and to exclude ketosis and diagnosis of diabetic ketoacidosis (DKA) in hyperglycemic children. Diabetes mellitus, Hyperglycemia, Diabetic ketoacidosis, Point-of-care testing, Ketosis, Urine ketones, Acetoacetates.

Role of Salivary Uric Acid Versus Serum Uric Acid in Predicting Maternal Complications of Pre-Eclampsia in a Rural Hospital in Central India: A Two-Year, Cross-Sectional Study.

BackgroundHypertensive disorders during pregnancy are an important topic of concern, specifically in rural and remote areas of India where there is a lack of awareness and it is difficult to maintain proper follow-up of pregnant females to screen them for complications developed during pregnancy. Gestational hypertension and pre-eclampsia result in the abruption of the placenta, hemolysis, elevated liver enzymes, low platelet count syndrome, eclampsia, and disseminated intravascular coagulation, which can be a serious threat to the health of the mother and the fetus. Therefore, it is important to identify biomarkers for diagnosing and predicting the complications of pre-eclampsia that may aid the obstetric high-dependency units based in rural areas to tackle this important health hazard during pregnancy.MethodologyA total of 180 singleton pregnant women of more than 34 weeks of gestational age were enrolled in this study. All women were divided into three groups (control group, severe pre-eclampsia, and non-severe pre-eclampsia) based on the severity of blood pressure and the presence of proteinuria (≥+1 by the dipstick method). Salivary and serum uric acid levels were measured through morning samples, and all patients were monitored for the development of complications and outcomes. Salivary uric acid and serum uric acid levels were correlated with each other and with maternal complications of pre-eclampsia.ResultsMean salivary uric acid (mg/dL) in severe pre-eclampsia was (6.72 ± 0.49) significantly higher compared to non-severe pre-eclampsia (4.75 ± 0.94) and control (3.13 ± 0.43). Mean serum uric acid (mg/dL) in severe pre-eclampsia was (8.13 ± 0.87) significantly higher compared to non-severe pre-eclampsia (6.23 ± 0.76) and control (3.85 ± 0.46).The lowest best cut-off value of maternal salivary uric acid was 5.06 mg/dL, above which one can predict maternal complications with a diagnostic accuracy of 78.33%.ConclusionsSalivary uric acid and serum uric acid levels are significantly raised in cases of pre-eclampsia in comparison to normal pregnancy. Salivary uric acid and serum uric acid are correlated significantly indicating that salivary uric acid can function as a cost-effective, novel marker to provide an idea about serum uric acid levels. The prognostic accuracy of salivary uric acid was good in predicting maternal complications among cases of pre-eclampsia (severe and non-servere) and early-onset maternal complications. Therefore, it may be utilized as a helpful marker to identify high-risk patients.

A STUDY ON PROTEINURIA AS AN EARLY INDICATOR OF SYSTEMIC ENVENOMATION IN SNAKE BITE

Background: Snakebite is an important public health concern in developing countries. In India, it is estimated that 45900 deaths occur annually due to snake bites. Various studies have shown conicting views on the importance of proteinuria in venomous snake bites. Hence, this study intends to study proteinuria and assess whether it can serve as a reliable early indicator of systemic envenomation in snakebites. The objective of the study:To study the value of proteinuria as an early indicator of systemic envenomation in snakebite. Methodology: A Hospital-based Descriptive study was conducted in the Department of General Medicine, Santhiram Medical College, and General Hospital for six months after approval from the Hospital Ethics and Research Committee. Patients above 18 years presenting with an alleged history of snakebite were included in the study. Urine for proteinuria was tested using the dipstick method and followed up at 0, 6, 12, 18 and 24hours. A total of 60 patients were included in the study. Results: Out of 60 patients included in the study, the majority (64%) of the patients were in the age group of 18-50 years. The dorsum of the right foot was the most common site of bite amongst the patients. Proteinuria had a signicant correlation with deranged bleeding and renal parameters. Interpretation and conclusion- In the present study, it is evident that proteinuria was seen in patients with prolonged WBCT and deranged PT/APTT/INR, and it is observed that proteinuria appeared even before a clotting defect was detectable. Hence it would be of paramount importance to consider proteinuria as an indicator of systemic envenomation in snake bites.

Evaluation of microalbuminuria in obesity phenotypes.

BACKGROUND:Obesity is a universal health issue of the present time. Nearly 2 billion people were estimated to be either overweight or obese in 2020, with nearly 3.4 million deaths worldwide. Proteinuria is now widely known to be a significant predictor of renal pathologies including end-stage renal disease. This study aimed to assess the relationship between the presence of microalbuminuria (MA) in obese individuals.MATERIALS AND METHODS:This cross-sectional study was conducted among patients attending the outpatient department of Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha. From the subjects meeting the study criteria, selected 150 individuals with BMI ≥ 25 that formed the obese group. Obese individuals were further subdivided as metabolic healthy obese (MHO) and metabolic abnormal obese (MAO) based on metablic syndrome criteria. From the non-obese patients (BMI≤25), one age and gender matched control was selected for each obese subject. All subjects were tested for MA by dipstick method. Data was analyzed using SPSS and Chi-square test was performed to test for statistical significance.RESULTS:The study reflected the association of MA in the groups studied. The metabolic abnormal obese group was noted as having the highest percentage of positive cases (53.7%) of MA, followed by the MHO group (31.3%). A significant association of prevalence of MA was seen in MHO and MAO obese individuals (P < 0.001). MA was present in the urine samples of 26 (31.3%) obese subjects in the MHO group, 36 (53.7%) in the MAO group, and 8 (5.3%) in the control population.CONCLUSION:Both MHO and MAO subgroups of obese individuals showed higher proportion of MA indicating adverse renal function. Therefore, primary prophylactic measures such as health education and lifestyle modification should be promoted for the obese to reduce their body weight and thereby possibly reduce the risk of future obesity-related renal complications.

Utility of Urinary Nephrin in Patients With and Without Diabetic Nephropathy and Its Correlation With Albuminuria.

IntroductionNephrin is a podocyte-specific protein that may serve as a urinary biomarker in patients with diabetic nephropathy. The objectives of the study were to determine urinary nephrin levels in patients with and without type 2 diabetic nephropathy and to assess the correlation between urinary nephrin and albuminuria.MethodsThis was a cross-sectional comparative study that was carried out at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry over 18 months. Diabetic study subjects were divided into three groups-normoalbuminuria, microalbuminuria, and macroalbuminuria. Urinary albumin was detected by the dipstick method in a spot urine sample for all study subjects. In subjects with trace or no albuminuria, nephelometry was used to quantify urinary albumin levels. Urinary nephrin was estimated by the ELISA technique for all study subjects.ResultsSubjects in the microalbuminuria group had higher urinary nephrin levels than those in the normoalbuminuria and macroalbuminuria groups. There was a weak positive correlation between urinary albumin and nephrin levels among the study subjects (p < 0.001).ConclusionUrinary nephrin levels are increased in patients with diabetic nephropathy. There was a weak positive correlation between urinary albumin and nephrin levels among these patients.

Haemato-biochemical Alterations in Obstructive and Non-obstructive Renal Diseases

Background: Diseases involving urinary system are very common in dogs causing significant morbidity and mortality in dogs. Renal failure and urinary obstruction are frequently encountered in clinical cases. Early diagnosis and treatment increase the survival rate and decreases the chances of complications related to renal failure. The present study was conducted to evaluate haemato-biochemical alterations in dogs having urinary system dysfunction. Methods: The study was conducted on 38 dogs to observe the haemato-biochemical parameter changes in dogs suffering from obstructive and non-obstructive renal system affections as compared to healthy dogs. Various haemato-biochemical parameters viz. Hb, PCV, TEC, TLC, DLC, BUN, creatinine, ALT, AST, ALP, TP, albumin and A:G ratio were evaluated. Qualitative analysis of urine was done using Multistix dip stick method. Result: In the present study the values of various haemato-biochemical parameters showed different pattern in both obstructive and non-obstructive renal diseases. Significant haematobiochemical changes reported in renal failure dogs were anemia, azotemia, increased alkaline phosphatase and AST values and decreased A:G ratio and in dogs with urinary obstruction the significant changes were uremia and leukocytosis. The results of the study suggested that the evaluation of various haemato-biochemical parameters help in diagnosis and predicting the prognosis of a renal disease.