Normal Blood Serum Research Articles

Dialysate cyclophilin A as a predictive marker for historical peritonitis in patients undergoing peritoneal dialysis

IntroductionNo markers have been used to diagnose historical peritoneal dialysis (PD)-related peritonitis. Cyclophilin A (CypA) is associated with glucose toxicity and inflammation. We hypothesize that dialysate CypA can be a marker for historical peritonitis (at least 3 months free from peritonitis). MethodAn enzyme-linked immunosorbent assay kit was used to measure the concentration of dialysate CypA. Clinical and laboratory data were collected to correlate with historical peritonitis. Mann-Whitney U test and Chi-square test were used for analysis. Receiver operating characteristic (ROC) analysis was used to evaluate predictive power. ResultsOut of a total of 31 patients who had undergone PD for at least 2 years, 18 had no history of PD-related peritonitis, while 13 had experienced PD-related peritonitis at least once. Overall, the patients in this population were in good health (normal white blood cell count, no anemia, normal electrolyte and serum albumin levels). There were no significant differences between patients with and without a history of peritonitis, except for blood white blood cell count (5650.6 ± 1848.4 vs. 7154.6 ± 2056.8, p = 0.032) and dialysate CypA value (24.27 ± 22.715 vs. 54.41 ± 45.63, p = 0.020). In the univariate analysis, only the dialysate CypA level showed a statistically significant association with historical peritonitis (HR = 1.030, 95 % CI = 1.010–1.062, p = 0.046). The AUC for dialysate CypA (>34.83 ng/mL) was 0.748, with a sensitivity of 0.615 and specificity of 0.833. ConclusionPD peritonitis poses a significant threat to the long-term use of peritoneal dialysis. Based on our study, even in the absence of concurrent infection, dialysate CypA can serve as a predictive marker for historical peritonitis, demonstrating high predictive power along with fair sensitivity and good specificity.

Clinical features, laboratory findings and treatment of juxtaglomerular cell tumors: a systemic review.

Juxtaglomerular cell tumors (JGCTs) or reninoma are rare kidney tumors leading to secondary hypertension, and the non-specific clinical manifestations bring about challenges to the diagnosis. This study is to summarize the clinical features, laboratory findings, and treatment of JGCTs. The PubMed, EMBASE database, and manual search were utilized to find all cases, and 158 reports containing 261 patients were identified. Data on patients' demographics, clinical features, diagnostic methods, and treatment options were collected and analyzed. JGCTs occurred predominantly in female patients (female to male ratio, 2.1:1). The median age of patients was 25 years (IQR:18-34 years). Hypertension (97.24%) was the cardinal manifestation. Hypokalemia was reported in 78.71% (159/202) of subjects, and normal serum potassium accounted for 20.79% (42/202). In cases with assessed plasma renin activity (PRA) levels, the median PRA was 7.89 times the upper limit of normal (IQR:3.58-14.41), and 3.82% (5/131) of cases in the normal range. Tumors were detected in 97.8% (175/179) computed tomography (CT), 94.7% (72/76) magnetic resonance imaging (MRI), and 81.5% (110/135) ultrasound, respectively. For 250/261 patients undergoing surgical procedures, 89.14% (197/221), 94.94% (150/158), and 100% (131/131) of patients were restored to normal blood pressure, PRA, and serum potassium, respectively. JGCTs are commonly associated with hypertension, hypokalemia, and hyperreninemia, whereas patients with normotension, normokalemia, and PRA should be systematically pursued after drug-elution lasting for 2 weeks. CT and MRI are more sensitive imaging diagnostic methods. The blood pressure and biochemical parameters of most patients returned to normal after surgery.

77 Case series of juvenile scleroderma from Nigeria

BackgroundThe word scleroderma means ‘hard skin’ that develops due to excessive accumulation of collagen. It is the third most frequent rheumatic disease in paediatric rheumatology after juvenile idiopathic arthritis and systemic lupus erythematosus. When it occurs in individual <16 years, it is called juvenile scleroderma. It is a rare disease that occurs in one per million children, documented to be more common in African adults with poorer survival states compared with Caucasians.Objectives To describe the clinical and laboratory characteristics of children with juvenile scleroderma seen in our clinic, thus, increasing its awareness.MethodsRetrospective review of records of three children diagnosed with juvenile scleroderma at the paediatric Rheumatology Clinic of Lagos State University Teaching Hospital(LASUTH) between May 2018 to April 2022.Results Case 1 A 12-year-old girl presented with skin tightness of the left hand and thigh of one year, contracture of the 3rd, 4th and 5th proximal interphalangeal joints, arthritis of the left wrist, skin induration of the dorsum of the left hand involving the 4th and 5th finger and extending to the wrist and skin and induration of the anterolateral aspect of the left thigh. Her blood tests showed an erythrocyte sedimentation rate (ESR) at 20 mm/h, an ANA titre of 1:2560, a negative anti-Scl 70/anti-centromere antibodies, a normal complete blood count and serum electrolytes/urea/creatinine. A diagnosis of linear scleroderma was made, the patient had prednisolone, methotrexate and folic acid, in addition to topical emollients. She improved clinically as observed during follow up visits six weeks after initiation of treatment but later defaulted from the clinic due to unknown reason. Case 2 A 4-year-old girl presented with constitutional symptoms, swollen hands and feet, sclerodactyly, narrowing of oral aperture, ulcers at tips of the fingers, inflammatory pain of the large joints, hypopigmented macules on the face, trunk, abdomen and back and also abnormal capillaroscopy. Erythrocyte sedimentation rate was 22 mm/h with normal levels of electrolytes/urea/creatinine, thrombocytosis, ANA titre of 1:640 and negative anti-centromere and anti-U1RNP antibodies. A diagnosis of diffuse systemic sclerosis was made. She started prednisolone, methotrexate, nifedipine and omeprazole and was asked to do an ECG, an Echocardiogram, a spirometry and a chest HRCT but she couldn’t afford to do these investigations due to severe financial constraints. She was clinically stable for four months until she presented at the emergency room with sudden loss of consciousness and congestive cardiac failure. She died during resuscitation attempt. Case 3 An 11-year-old girl known patient of haematology unit with sickle cell anaemia, presented with inflammatory arthritis of the small joints of the hands, elbows and knees of nine-month duration, sclerodactyly, contractures of the PIP of the fingers, narrowing of oral aperture, generalized hypopigmented macules and abnormal nailfold capillaroscopy. Investigation showed an ANA titre of 1:640, positive anti-Scl 70 antibodies, negative anti-centromere antibodies, ESR of 130 mm/h and thrombocytosis. The echocardiogram showed a normally structured heart with severe restriction on spirometry and features of interstitial lung disease on HRCT of the chest. She started mycophenolate mofetil, prednisolone and nifedipine. She later received 2 doses of rituximab due to slow clinical improvement. She is being followed up.ConclusionMost data on scleroderma are from adult studies, we reported these three cases due to the rare occurrence of scleroderma in children, thus increasing its awareness.

To Investigate the Refractive Index of Blood Plasma Suspended in Various Tonicity Solutions

This paper reports the data of the RI of plasma of normal blood, which is measured using Abbes' refractometer. The experimental values are compared to normal blood serum erythrocytes with Blood of Plasma suspended in various tonicity solutions between and 1.336 to 1.343, whereas the normal blood plasma refractive index is 1.351. As a result, the refractive index the worth of erythrocytes washed with different tonicity solutions are slightly lower than those of normal blood. If this optical parameter is standardized, it has the potential to be used as a tool in the medical field.

ASSOCIATION BETWEEN CRP, D-DIMER, SERUM FERRITIN, INITIAL CT- CHEST SEVERITY SCORE AND THE OUTCOME OF COVID-19 IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Introduction: The surge of Covid -19 pandemic and the earlier depletion of resources have led to the need of allocation of patients based on levels of risk. The COVID 19 related mortality has been on increase in people with old age, male gender, inammatory markers elevation and in people with history of co morbidities. With this background, thus study aimed to observe association between CRP, D-Dimer, Serum Ferritin, The Initial CT Chest Severity Score and the outcome of Covid 19 in patients with Type 2 Diabetes mellitus. A hospital based retrospective study was done among COVID 19 patients from the period of September toMaterials and methods: December 2020. Patients with Type 2 diabetes mellitus admitted with RT-PCR positive (or) CT Thorax – CORADS 4 and above with age more than 18 years and having CRP, D-Dimer, Serum Ferritin results within 24 hours after admission were included in the study. The data was collected using a semi structured questionnaire. A total of 531 individuals were participated in the study. The mean respiratory rate and oxygenResults: saturation between the survived and deceased groups was statistically signicant (p value 0.024 and 0.044 respectively). All the patients had normal blood urea and serum creatinine values. The mean CORADS score of the participants is 4.78 ± 0.60. There is statisticallyConclusion: signicant difference in the mean respiratory rate and mean SPO2 between deceased and recovered patients. With advancements in medical sciences, it may not be a rigid process to predict severity with laboratory investigations.

Determination of blood cholesterol concentration using calibration-based laser plasma spectroscopy and Fourier transform infrared technique

In this paper, the analysis of blood cholesterol is demonstrated using calibration curves derived from laser-induced breakdown spectroscopy (LIBS) and Fourier transform infrared (FTIR) technique. First of all, five standard samples and one target sample are prepared by adding different concentrations of cholesterol (as the analyte) to normal human blood serum (as the matrix). The plasma emission spectrum of the above samples is measured through LIBS process. Subsequently, considering the constituent elements of cholesterol (C27H46O), the relative average intensity of spectral lines having appropriate signal-to-noise ratio related to these elements is calculated. In the next step, four calibration curves of the relative average intensities are drawn in terms of cholesterol concentration of the samples. Finally, the target cholesterol concentration and its standard error of the mean (SEM) are obtained by the use of the calibration curves. In another way, cholesterol concentration of the target is also examined using the FTIR spectrum of the samples. Absorption bands corresponding to vibrational modes of the cholesterol molecule are identified. Then, the transmittance of the identified absorption peaks is plotted versus the blood cholesterol of the standard samples, and the cholesterol concentration of the target is determined by the resulted calibration lines. The results yielded from both LIBS and FTIR technique are in very good agreement with each other and with the certified value of the target cholesterol concentration, which once again indicates that in the molecular analysis, in addition to FTIR technique, LIBS method can also be very efficient.

Evaluation of the Effects of Spinel Ferrite Nanoparticles on the Composition of Normal Human Blood Serum

Evaluation of the Effects of Spinel Ferrite Nanoparticles on the Composition of Normal Human Blood Serum

An Unusual Case of Bilateral Adrenal Hyperplasia

Background: Thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly (TAFRO) syndrome is a variant of Castleman Disease, which is a rare lymphoproliferative disease that can be life threatening. Diagnosis is often delayed because of its nonspecific presentation. Bilateral adrenal hyperplasia has been a reported complication, however the majority of cases reported have been in Asian patients. Prior accounts of elevated ACTH in TAFRO have been in the context of adrenal insufficiency. Clinical Case: A 28-year-old Caucasian male with a history of multiple sclerosis was seen in the ED with abdominal pain. On presentation, he was afebrile and normotensive. Physical exam was notable for cervical lymphadenopathy and abdominal tenderness. There was no facial rounding/plethora, bruising, abnormal striae, or proximal muscle weakness. He had normal blood counts, serum chemistry and liver function. An abdominal CT scan showed marked bilateral adrenal hyperplasia with pre-aortic, peri-aortic and retroperitoneal lymphadenopathy. An 8AM serum cortisol was 14.1 mcg/dl (4.8–19.6 mcg/dl) and adrenocorticotrophic hormone (ACTH) was elevated at 152 pg/ml (7.2–63 pg/ml). A repeat serum 8AM cortisol following low dose dexamethasone suppression test (LDDST) was 14.7 mcg/dl, however at that point the patient had developed new fevers and thrombocytopenia. Blood pressure, blood glucose and potassium remained normal. An MRI of the brain showed a normal appearing pituitary gland. An extensive infectious and rheumatologic evaluation was negative, and he underwent an inguinal lymph node biopsy which showed nodal expansion with histiocytes, consistent with TAFRO. High dose methylprednisolone and Siltuximab (an IL-6 inhibitor) were started, and his fever and abdominal pain resolved. He was discharged home on oral prednisone. Conclusion: We describe a case of bilateral adrenal hyperplasia with elevated ACTH and non-suppressed cortisol on LDDST suggestive of ACTH-driven cortisol excess. However, interpretation of his LDDST is made difficult in the context of persistent fevers. Although we cannot definitively exclude pathologic hypercortisolism at this time, given his lack of suggestive features such as proximal muscle weakness, abnormal striae or hypokalemic alkalosis, his over-all presentation was more consistent with hyperplasia secondary to TAFRO rather than an underlying pathologic hypercortisolism. Adrenal hyperplasia has been noted in TAFRO, however its pathogenesis remains poorly understood. TAFRO should be added among the differentials for bilateral adrenal hyperplasia to facilitate early diagnosis and treatment.

Growth Performance, Nutrient Digestibility and Blood Indices of West African Dwarf Goats Fed Graded Levels of Broiler Litter

Background: A study was conducted to investigate effects of broiler litter (BL) on growth performance, nutrient utilization, blood haematology and serum biochemistry of West Africa Dwarf (WAD) goats. Methods: Five complete diets were formulated using BL to replace 40% composition of cottonseed cake at 0 (control), 25, 50, 75 and 100%. Thirty WAD bucks weighing 10.57±0.42 kg were randomly allotted to the five treatments in a randomized complete block design (RCBD). Result: The results revealed that daily feed intake (g) and final weight gain (kg) were statistically similar (p greater than 0.05), but daily feed intake cost (N) and feed cost per kg gain (N/kg) decreased (p less than 0.05) across the treatments. Dry matter and organic matter digestibility increased (p less than 0.05), while neutral detergent fibre and acid detergent fibre digestibility decreased (p less than 0.05) across the diets. There was no statistical difference (p greater than 0.05) in N intake, faecal N, urine N and N retained (as % N intake). The serum biochemistry and haematological parameters were statistically similar (p greater than 0.05). Therefore, replacing 100% of CSC with BL maintained body growth; reduced cost of feed; improved nutrient digestibility and maintained normal blood haematology and serum biochemistry.

In Vitro Biostimulation of Low-Power Diode Pumping Solid State Laser Irradiation on Human Serum Proteins.

Objective: This research is conducted to clarify whether the action of low-power diode pumping solid state (DPSS) laser doses modify proteins of normal human blood serum in vitro. Background data: Low-power laser light is considered to act through biostimulation rather than through thermal effects. It was found that low-power laser light biostimulates various biological processes, such as increasing the blood flow within the microcirculation. Methods: Human blood serum samples were carefully collected and divided into five equal aliquots. One of them served as a control (nonirradiated serum) and the other four aliquots were irradiated by DPSS laser at a wavelength of 589 nm with different doses (50, 70, 90, and 110 J/cm2). The electrophoretic migration speeds of each specific protein were measured immediately after irradiation using protein electrophoresis. A paired Student's t-test was used between variables. Results: The protein concentrations were not significantly (p > 0.05) changed by the various doses of DPSS laser comparing with the nonirradiated counterpart. The electrophoretic migration speed of serum proteins was significantly decreased in almost all tested doses relative to the nonirradiated counterpart. Moreover, the irradiation of serum proteins (albumin, alpha1, alpha 2, beta, and globulin) with a laser dose of 70 J/cm2 was associated with a significant decrease (p < 0.003, 0.02, 0.002, 0.02 and 0.001, respectively) in protein migration speed compared with the protein migration speed of the control nonirradiated counterpart. Conclusions: Laser light at a wavelength of 589 nm induces processes that lead to decreases in serum protein migration speeds. Globulin protein was found to have the lowest migration speed among the other plasma proteins.

Targeted Tumor Therapy with Radiolabeled DNA Intercalator: A Possibility? Preclinical Investigations with 177Lu-Acridine.

Objective A DNA intercalating agent reversibly stacks between the adjacent base pairs of DNA and thus is expected to exhibit preferential localization in the tumorous lesions as tumors are associated with enhanced DNA replication. Therefore, radiolabeled DNA intercalators are supposed to have potential to be used in targeted tumor therapy. Working in this direction, an attempt was made to radiolabel 9-aminoacridine, a DNA intercalator, with 177Lu, one of the most useful therapeutic radionuclides, and study the potential of 177Lu-acridine in targeted tumor therapy. Experiments. 9-Aminoacridine was coupled with p-NCS-benzyl-DOTA to facilitate radiolabeling, and the conjugate was radiolabeled with 177Lu. Different reaction parameters were optimized in order to obtain 177Lu-acridine complex with maximum radiochemical purity. In vitro stability of the radiolabeled complex was studied in normal saline and human blood serum. Biological behavior of the radiolabeled agent was studied both in vitro and in vivo using the Raji cell line and fibrosarcoma tumor-bearing Swiss mice, respectively. Results 177Lu-acridine complex was obtained with ~100% radiochemical purity under the optimized reaction conditions involving incubation of 1.5 mg/mL of ligand with 177Lu (1 mCi, 37 MBq) at 100°C at pH ~5 for 45 minutes. The complex maintained a radiochemical purity of >85% in saline at 6 d and >70% in human serum at 2 d postpreparation. In vitro cellular study showed uptake of the radiotracer (5.3 ± 0.13%) in the Raji cells along with significant cytotoxicity (78.06 ± 2.31% after 6 d). Biodistribution study revealed considerable accumulation of the radiotracer in tumor 9.98 ± 0.13 %ID/g within 1 h postadministration and retention therein till 6 d postadministration 4.00 ± 0.16 %ID/g with encouraging tumor to nontarget organ uptake ratios. Conclusions The present study, although preliminary, indicates the potential of 177Lu-acridine and thus radiolabeled DNA intercalators in targeted tumor therapy. However, further detailed evaluation is required to explore the actual potential of such agents in targeted tumor therapy.

Tobramycin Serum Concentrations in Tracheostomy-Dependent Children Receiving Inhaled Tobramycin.

Introduction: In recent years, administration of inhaled aminoglycosides has gained popularity in tracheostomy-dependent pediatric patients because of medication delivery to the target site of action while minimizing systemic absorption and adverse effects. A recent report of detectable serum tobramycin concentrations in critically ill children receiving inhaled tobramycin 300 mg every 12 h prompted our investigation in tracheostomy-dependent pediatric patients receiving inhaled tobramycin 80 mg every 8 h. Methods: Serum tobramycin trough concentrations were obtained from tracheostomy-dependent pediatric patients receiving treatment with inhaled tobramycin 80 mg every 8 h for the treatment of tracheitis. Patient data, including demographic data, medical history, renal function, and serum concentrations, were collected. Results: Twelve patients with a median age of 0.5 (0.3-6.1) years had serum tobramycin concentrations evaluated. Eleven of the 12 patients had undetectable trough concentrations (<0.6 mcg/mL). All of these patients had normal blood urea nitrogen (BUN) and serum creatinine (SCr) for age and no history of kidney disease. One patient had a detectable trough concentration of 2.1 mcg/mL. This patient was 11 months old and had polycystic kidney disease with an elevated BUN and SCr for age. Conclusions: Detectable serum concentration from systemic absorption of inhaled tobramycin 80 mg every 8 h is unlikely in tracheostomy-dependent pediatric patients with normal renal function. However, in tracheostomy-dependent pediatric patients with a history of renal dysfunction or elevations in BUN or SCr, inhaled tobramycin should be used with caution. Monitoring serum concentrations to guide dose modification should be considered in these patients.

SAT-LB312 Central Diabetes Insipidus as Presenting Manifestation of Suprasellar Epidermoid Cyst

Back Ground: Epidermoid cysts (ECs) result from the inclusion of squamous epithelial elements during neural tube closure. ECs are tumors constituting 02-1.8% of all brain tumors. ECs are typically found in cerebellopontine angle, but occasionally develop in sellar region. ECs are usually clinically silent, but may produce signs of mass effect as headaches, visual field defects. ECs presenting with Central Diabetes insipidus is reported but rare. Only two cases were reported in literature (Ref: 1).Here we report a case of sellar Epidermoid cyst presenting with Diabetes insipidus. Case Description: 49-year male presented with one-month history of polyuria, polydipsia and weight loss. The initial work up identified normal blood glucose, serum calcium and renal function. The water deprivation test confirmed the diagnosis of central Diabetes insipidus. Further pituitary hormonal assessment revealed panhypopituitarism along with diabetes insipidus. The MRI of brain showed evidence of large sellar supracellar cystic mass with a differential diagnosis of craniopharyngioma, Rathkeys cyst. Surgery performed in order to remove the tumor. The pathological report confirmed the tumor as epidermoid cyst. He did well through hospital stay. DI and along with panhypopituitarism persisted post operatively and treated with hormonal replacement. Conclusion: ECs of sellar region vary in presentation depending upon their location, and extension into surrounding areas producing mass effects. Diabetes Insipidus is a rare presentation in these rare tumors.

A study on microvascular complications in patients with newly detected Diabetes Mellitus

Introduction: Microvascular complications such as diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy are associated with considerable medical and economic impact among persons with diabetes. In the UK Prospective Diabetes Study [UKPDS], 37% of patients with newly diagnosed type 2 diabetes developed at least one microvascular complication over a ten years period. Methodology: The procedure was told to the patients. 5.07 Simmes Weinstein monofilament consisted of a plastic handle supporting a nylon filament. The filament was placed perpendicular to the skin of the foot, and the pressure was applied until the filament buckles. The filament was held in place for approximately 1 second, then released. The patients were asked to elicit a ‘Yes/No’ response to monofilament pressure and correctly identify the site of contact. Inability to perceive the 10 g of force it applies was associated with clinically significant large fibre neuropathy. Like this 9 plantar sites and 1dorsal site were tested in each foot. Results: Statistical analysis of above obtained data reveals that patient with HbA1c ≥8% have 4.4 times higher risk of developing microvascular complications than patient with HbA1c ≤8%. This indicates HbA1c is a better predictor of microvascular complications in diabetics. Most of the patients had normal Blood urea and Serum creatinine levels. 25 patients had urea > 40mg/dl. 2 patient had creatinine > 2mg/dl. Conclusion: It is clear that significant increase in Blood urea and Serum creatinine levels which is indicative of renal involvement is less common at diagnosis of diabetes mellitus.

Prediction of maternal diabetes and adverse neonatal outcome in normotensive pregnancy using serum uric acid

Diabetes mellitus, with adverse neonatal events are challenging issues to all obstetricians and pediatricians, where uric acid could play a vital role. We aimed to assess the relationship and prognostic benefits of serum uric acid measured at about 20 weeks’ gestation in normotensive pregnancy, with subsequent maternal diabetes, and neonatal complications. All singleton normotensive pregnant women with normal blood glucose, serum creatinine, and weight before pregnancy, whom attended Medical City Hospital, Department of Obstetrics and Gynecology in Baghdad, were involved and regarded as the case group, on the condition that their serum uric acid measured at 20 weeks’ gestation &gt; 3 mg/dl, but if ≤ 3 mg/dl, they would be registered as a control group. A complete follow up was performed regularly during pregnancy, and after delivery; regular assessments of maternal blood glucose were done up to one year. Maternal diabetes mellitus (DM), small for gestational age (SGA) neonates, and preterm delivery (PD) constituted (27.59%), (43.60%), and (1.97%), respectively in case group which had significantly included maternal DM and SGA (P &lt;0.001). Also, elevated mid-pregnancy serum uric acid was strongly associated (P &lt;0.0001) with maternal DM (5.86 ± 0.69) and SGA (4.78 ± 0.34). Cut-off values of uric acid of 4.76 mg/dl were best associated with maternal DM, while 4.33 mg/dl with SGA. In conclusion, the cut-off points of 4.76 and 4.33 mg/dl of maternal mid- normotensive pregnancy serum uric acid have the potential ability to predict Maternal DM and SGA, respectively.

Renal histopathological and biochemical changes following adjuvant intervention of Momordica charantia and antiretroviral therapy in diabetic rats.

Objective(s):Diabetic nephropathy (DN) is an important primary cause of end-stage kidney disease. This study explores the mechanisms of the reno-protective effects of Momordica charantia (M. charantia) in diabetic rats following treatment with highly active antiretroviral therapy (HAART) regimen triplavar. Materials and Methods:Adult male Sprague-Dawley rats (n=48) were divided into 7 groups (A-G).Treatment groups (B-G) had 7 animals per group and control group (Group A) had 6 animals per group. Diabetes was induced with streptozotocin (STZ) by intraperitoneal injection (STZ 45 mg/kg body weight). The animals were euthanized on the tenth week with kidneys removed for examination and blood obtained via cardiac puncture. Results:Key renal parameters showed no albuminuria, normal blood urea nitrogen (BUN), serum creatinine and electrolytes in all groups treated with M. charantia. Untreated diabetic (Group B) and HAART treated diabetic (Group C) showed severe albuminuria, a significantly raised BUN and serum creatinine (P<0.05) and gross electrolyte disturbances. Blood glucose levels were consistently and significantly raised in all groups not receiving the adjuvant M. charantia (P<0.05). Levels of oxidative stress enzymes Superoxide dismutase (SOD), Catalase and activities of Reduced Gluthaione (GSH) and Malondiadehyde (MDA) were significantly lower in all groups not receiving M. charantia. Histopathology in untreated diabetic and HAART treated animals showed severe degenerative changes in the glomeruli and inflammatory cellular infiltration while M. charantia treated animals showed an essentially normal glomerular appearance with capillary loops and normal cytoarchitecture. Conclusion: M. charantia extract administration improved blood glucose levels, reinstates renal function, reduces body weight loss and restores hyperglycemia.

Nanoliposomes of Supercritical Carbon Dioxide Extract of Small Cardamom Seeds Redresses Type 2 Diabetes and Hypercholesterolemia.

In our previous investigation, oral administration of 1,8- cineole-rich supercritical carbon dioxide extract of small cardamom seeds in Wistar albino rats resulted in achieving normal fasting blood glucose (FBG) and serum cholesterol levels. The objective of this study was to further protect the aforesaid extract and to enhance its in vivo therapeutic efficacies in redressing type 2 diabetes and hypercholesterolemia, by encapsulating it as nanoliposomes. Patents related to nanoliposomes have been revised thoroughly. PEGylated nanoliposomes of the aforesaid extract were formulated using soya phosphatidylcholine and Tween 80 by probe-sonication. These nanoliposomes were subjected to in vitro characterizations and were orally administered to Wistar albino rats at three different doses viz. 550, 175 and 55 mg/kg b.w. for detailed investigation of their antidiabetic and hypocholesterolemic efficacies. FT-IR, DSC and XRD analyses, HLB value (16), entrapment efficiency (84%) and release kinetics (obeying Higuchi model) revealed that the nanoliposomes were o/w type and were hydrophilic. They exhibited appreciable in vitro antioxidant potency (59% DPPH scavenging activity) owing to a synergistic consortium of antioxidants present therein. Oral administration of the liposomes in rats at 550 mg/kg b.w. could restore their normal FBG levels and serum lipid profiles on day 35, with desirable up-down regulations of related key enzymes. The iHOMA2 model could successfully predict the effects of nanoliposomes on insulin sensitivity and glucose uptake in rat liver and brain, respectively. Nanoliposome of 1,8-cineole rich extract of small cardamom seeds is a new biotherapeutic in redressing type 2 diabetes and hypercholesterolemia.

To study the influence of iron deficiency anaemia on hba1c in diabetic screening

Introduction: HbA1c is used for monitoring glycaemic control and to predict diabetic complications. IDA attributes to 50% of all forms of anaemia, globally. Reduced iron stores have a link with increased HbA1c, leading to false-high values of HbA1c. There is lack of clinical evidence suggestive of the influence of Iron Deficiency Anaemia on HbA1c.Objectives: To evaluate the association between Iron Deficiency Anaemia and HbA1c values.Methodology: Observational Cross-sectional study was conducted on 50 patients attending OPD/admitted to MVJ Medical College & Research Hospital, during the study period from January 2018 to December 2018. By Simple Random Sampling, patients with anaemia, normal fasting and postprandial plasma glucose levels, normal liver function tests, normal blood urea and serum creatinine levels were recruited for this study.Results: Twenty-Five participants were in the iron deficiency anaemia group and 25 in the control (normal) group. Mean Hb among cases was 8.48±1.5 (5.4 to 10.9 gm dL) and that among controls was 14.2±0.8 (12.3-15.5 gm/dL). The mean HbA1c was 6.5±0.6. The mean HbA1c for cases with Iron Deficiency Anaemia was more than that for healthy controls (7.1±0.3 and 6.0±0.3 respectively) (p-value

Vitamin D Deficiency in Recurrent Urinary Tract Infections in Children Under 5 Years Old in Salah Aldeen General Hospital

The aim of this study was carried out to determine the role of vitamin D deficiency in recurrent urinary tract infection in children below 5 years of age and importance of supplementation of vitamin D in such these infections. A cross sectional study hospital based was conducted in Salah Aldeen General Hospital-Iraq, during the period between 1st November 2017–27th February 2018. The study done on 100 children under 5 years old admitted to pediatric department, and classified into 2 groups (50 child with only recurrent urinary tract infection and free from other infections (cases) and 50 child was healthy children without infection (control). Most of cases was aged 2–3 years (26%), were female(64%), live in rural area about(84%), with only breast feeding (52%), about (64%) with illiterate mothers, most of them delivered in winter about (66%), with low socioeconomic level (60%) and insufficient sun exposure (78%), most of them with deficient serum vit. D level about (58%) with normal blood urea and serum creatinin level (96%), and urine culture of the recurrent UTI cases (34%) was positive, and (66%) was negative, about (82%) of positive urine culture results was E.coli, (12%) Proteus, and (6%) Klebsilla infection.

Duodeno-Colonic Fistula Associated With an Intestinal Large B-Cell Lymphoma

Enterocolic fistulae are usually caused by conditions such as Crohn's disease and diverticulitis. Less commonly, it can also be seen in the setting of prior surgeries, foreign bodies, pancreatitis, or malignancy. Here we reported a rare case of a spontaneous duodeno-colonic fistula caused by intestinal large B-cell lymphoma. This is a 69 year old male with a history of diabetes mellitus who presented with diarrhea and weight loss of 20 pounds for 5 weeks. He described rapid onset of 5 to 6 daily episodes of non-bloody watery stools associated with nausea, but no vomiting, abdominal pain or fever. There was no recent use of antibiotics, no recent travel or sick contacts. He has no history of Crohn's disease or diverticulitis. He was afebrile and physical exam is unremarkable. Laboratory testing revealed normal complete blood count, electrolytes, serum calcium, thyroid-stimulating hormone, and hepatic panel. A computed tomographic (CT) scan of the abdomen showed mild wall thickening and stranding surrounding the proximal duodenum and the splenic flexure of colon that was measuring up to 15 mm in diameter and multiple enlarged lymph nodes within the mesentery. Additionally, there was suggestion of a duodeno-colonic fistula. An upper endoscopy and colonoscopy were performed. Upper endoscopy revealed a fistulous tract in the transverse duodenum with refluxing of stool, however no duodenal mucosal mass seen. On colonoscopy, a large infiltrative mass with fistula near the splenic flexure was identified, but the mass was not transferable to the proximal colon. Histology was consistent with diffuse large B-cell lymphoma which stained negative for CD3 strongly positive for CD20. The patient was taken to the operating room with colorectal and hepatobiliary surgery with plans for an en bloc left colectomy, partial gastrectomy and small bowel resection and partial pancreatectomy. His post-operative course was complicated by a pancreatic duct leak which is well managed with a percutaneous drain and he will soon be initiated chemotherapy. For sudden onset of diarrhea with associated systemic symptoms suspicious for an underlying organic cause, imaging and endoscopic evaluation should be considered. The initial treatment of enterocolic fistulae is to correct fluid and electrolyte abnormalities, but in our case, oncologic treatment of B cell lymphoma could not be initiated until after surgical resolution of nutrient wasting diarrhea.1610_A Figure 1. CT showed colonic wall thickening with possible duodeno-colonic fistula1610_B Figure 2. Colonoscopy showed a large infiltrative mass with fistula near the splenic flexure.1610_C Figure 3. Pathology showed colonic mass with fistula is identified extending from the colonic mucosa to the duodenal mucosa.