Serum and Erythrocyte Magnesium levels in Offsprings of Essential Hypertensive Parents.

Hypertension is an important public health challenge worldwide, 95% of which are primary or essential hypertension, where the exact causes are not known. It has been thought that magnesium level has an association with hypertension and plays role in the pathogenesis of essential hypertension. Several evidences suggested that decreased magnesium level may be a significant modifiable risk factor for developing essential hypertension. To explore the relationship between serum and erythrocyte magnesium level with blood pressure, this case control study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), during the year 2006. Thirty offsprings of essential hypertensive parents were taken as cases and 30 age and sex-matched offsprings of normotensive parents were taken as controls. Serum & erythrocyte magnesium were measured by colorimetric Calmagite method. Significantly lower serum magnesium level (mg/dl) was found in cases than that of controls (1.90±0.210 vs 2.13±0.366, p<0.01) and erythrocyte magnesium (mg/dl) was also found to be lower in cases when compared with that of controls (4.46±0.699 vs 5.43±0.775, p<0.001). Mean systolic and diastolic blood pressure were found to be significantly higher (p<0.01) in cases as compared to controls. Though it is difficult to draw any definite conclusion, it may be assumed that, a hereditary predisposition to hypertension may be related to magnesium metabolism and magnesium deficiency might have a role in the future development of hypertension in the offsprings of essential hypertensive parents.

Thyroid Status in Patients with Low Serum Ferritin Level.

Iron deficiency is the most important but preventable nutritional problem in Bangladesh. Thyroid peroxidase, an iron containing enzyme, is essential for initial two steps of thyroid hormone synthesis which is a component of tissue iron. Tissue iron diminishes early in the course of iron deficiency. So thyroid hormone level may be altered in iron deficient patients. This case-control study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2006 to June 2007. This study was done to find out the changes of thyroid hormonal activity in iron deficiency. In this study 72 subjects were selected from the out-patient department of the hospital. Patients with low serum ferritin level <12 mgm/L were selected as cases (n=36) and healthy persons with normal serum ferritin level were taken as controls. Serum ferritin, thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured in all study subjects. Values were expressed as mean ± SD. Unpaired 't' test and Pearson's correlation test were performed to see the level of significance and p value <0.05 was taken as significant. Serum ferritin level in cases and controls were 6.78±4.05 mgm/L and 79.04±28.08 mgm/L respectively which showed significant difference (P<0.0001). Serum TSH concentration in cases and controls were 3.32±1.54 mIU/L and 1.89±0.86 mIU/L respectively. Serum FT4 concentration in cases and controls were 11.66±1.77 pmol/L and 13/10±1.36 pmol/L respectively and that of FT3 were 3.00±0.68 and 3.31±0.61 pmol/L respectively. All showed significant difference between groups. Serum ferritin and Serum TSH showed significant negative correlation in controls whereas in cases they showed negative correlation which was not statistically significant. Both serum FT4 and FT3 revealed positive correlation with serum ferritin but that too was not significant statistically. Though the study failed to show any significant positive correlation between serum ferritin and thyroid hormones, lower level of thyroid status in iron deficient patients suggest that it could be a reflection of disturbed activities of iron dependent enzymes such as thyroid peroxidase that impairs thyroid hormone synthesis. However, a large scale study is recommeded to establish the fact. This study showed that there was significant difference in thyroid hormonal status between iron deficient patients and normal healthy persons. Therefore it can be concluded that iron deficiency may impair normal thyroid hormone status.

Characteristics of Insulin and Androgen Status in Polycystic Ovary Syndrome.

Polycystic Ovary Syndrome (PCOS) was originally described as a syndrome of amenorrhea, hirsutism and obesity associated with enlarged polycystic ovaries. There is increased androgen level and in some, insulin resistance (IR). Etiological relationship of androgen excess and IR in PCOS is not established. Influence of obesity on PCOS is controversial. This study was designed to see the androgen and insulin status in PCOS among obese and non-obese patients. It was a case-control study. Of total 80 study subjects, 60 primary infertile women suffering from PCOS were cases (30 obese and 30 non-obese). Age and BMI matched 20 healthy women having normal menstrual cycles were controls (10 obese and 10 non-obese). Age range of all were 20-40 years. Fasting plasma glucose, fasting S. Insulin and free Testosterone were measured. Insulin resistance (IR) was assessed by fasting glucose to insulin ratio (<4.5). Subjects with DM or known endocrine disorders that may be associated with abnormal S.Insulin or plasma glucose concentration were excluded. No significant difference of fasting plasma glucose between PCOS (obese or non-obese) and respective controls (P>0.5, in each) were observed. Significant difference of fasting S. Insulin and testosterone were observed between PCOS (both obese and non-obese) and respective controls (P<0.01 in each), but there was no significant difference between obese and non-obese PCOS (P>0.05). There was no significant difference of S.Testosterone between obese and non-obese PCOS(P>0.05). There was also no significant difference of IR between obese and non-obese PCOS, but the ratio was <4.5 (indicating IR in both). There were no significant correlation of S.Insulin with Testosterone in any group of PCOS (obese and non-obese) (P>0.05). Increased S.Insulin and Testosterone was seen in PCOS irrespective of BMI. Further studies with larger sample size is recommended to assess etiological relationship between insulin and testosterone in PCOS.

Role of cardiac troponin I in staging and prognosis of congestive heart failure subjects.

Congestive heart failure is the one of the major cardiovascular disorder that is increasing in incidence and cause of death globally. Mortality rate has increased 40%-50% in advanced cardiac failure and 15%-25% in mild to moderate cardiac failure within one year of diagnosis. There is no established biochemical marker for the diagnosis, prognosis and staging of heart failure. Cardiac Troponin I may be a novel useful tool in identifying patients with Heart failure who are at increased risk for progressive ventricular dysfunction and death. Thirty six congestive heart failure cases and thirty six healthy controls were included in this study and serum cardiac troponin I and Ejection fraction were measured. All the study subjects were grouped according to the NYHA class they belong. Cardiac troponin I was significantly higher in CHF cases than the controls. Troponin I also significantly differed among groups. EF of cases was significantly lower than the controls and also differed among groups. A significant negative correlation between cardiac troponin I and progressive decline of ejection fraction was evident in this study. Cardiac troponin I increased progressively with progression of heart failure. Thus, Cardiac troponin I could be used to stratify patients undergoing heart failure in to high and low risk groups for future cardiac events. Cardiac troponin I could also be used as a very important marker for the prognosis of the patients with congestive heart failure.

Spot morning urine protein creatinine ratio and 24 hour urinary total protein excretion rate.

Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. An alternate approach avoiding arduous and inaccurate timed urine collection can be the measurement of protein creatinine ratio in spot morning urine. This study was aimed to evaluate whether the spot morning urine protein creatinine ratio can be a reliable alternative to 24-hour urinary total protein (UTP) estimation. The study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka on 50 (fifty) non-diabetic Chronic Renal Disease (CRD) patients with an age ranging from 18 -70 years. The study subjects were grouped into mild, moderate and severe CRD on the basis of GFR. Urinary protein and creatinine concentrations were measured in spot morning urine samples and their ratios were calculated. Urinary protein measured in 24-hour timed collected urine samples gave the 24-hour UTP excretion rate. In our study, spot morning urine protein creatinine ratio significantly correlated with 24-hour UTP excretion rate in all CRD patients. Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.

Lipoprotein -- an independent risk factor for CVD.

A case control study done to evaluate the Lipoprotein(a) [LP(a)] as a risk factor for CVD (cerebrovascular disease). 150 non-smokers, non-alcoholic subjects free from DM, renal disease, thyroid disease and liver disease were included in the study. Among them 120 were CVD cases and 30 were age and sex matched healthy control. Subjects were grouped as group-I (30, healthy control), Group-II (60, Hemorrhagic CVD) and group-III (60, Ischemic CVD). Fasting (12 hr) blood samples were collected from all subjects and in CVD cases samples were collected after 24 hr of attack. Lipid profile and LP(a) conc. were measured in all samples. Mean serum LP(a) conc. in Group-I, Group-II and Group-III were found to be 17.6 7.4 mg/dl, 31.9 15.6 mg/dl and 44.8 24.0 mg/dl respectively. Both the groups of CVD cases showed significantly higher level of serum LP(a) conc. compared to healthy control. CVD cases did not differ statistically in respect of their lipid profile when compared with control. Moreover the serum LP (a) conc. of CVD cases found to show no correlation with their lipid profile, suggesting the serum LP(a) conc. a possible independent risk factor for CVD.

Serum homocysteine concentration in patients with acute MI and chronic IHD.

This was an observational study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka; with the active co-operation of Coronary Care Unit (CCU) of BSMMU & National Institute of Cardiovascular Disease (NICVD), Dhaka. This study was carried out from March 2002 to January 2003. Total seventy (70) subjects were studied. Out of them 20 were of Acute MI, 20 were Chronic ischemic heart disease (CHD) and 30 were age and sex matched healthy controls. Hospitalized diagnosed patients were selected by taking history, clinical examination and several investigations like ECG. Echocardiogram, Angiogram and several enzymes assay. Several studies in many countries showed that serum homocysteine (Hcy) was elevated in IHD Patient. Cardiovascular disease is alarmingly increasing in Bangladesh. So our aim and objective of the study was to find out the association of serum Hcy with Acute MI and chronic ischemic heart disease (CHD) patients in our population. Mean Hcy level of Acute MI were 21.16 +/- 4.56 (micromol/l), 27.55 +/- 10.40 (micromol/l) and that of control was 13.03 +/- 10.51(micromol/l). Serum Hcy was significantly higher in both cases than control. But insignificant difference was found between AMI vs CHD (P> 0.05). Quantitative measurement of serum Hcy was measured by fluorescence polarization Immunoassay (FPIA) in IMX analyzer (Abbott-USA).

Lipoprotein-a: a laboratory tool for clinical categorization of CVD.

A case-control study was done to evaluate the association of Lipoprotein(a)[LP(a)] with CVD (Cerebrovascular disease) and also to assess the implication of serum LP(a) concentration as a differentiating marker between ICVD (Ischemic CVD) & HCVD (Hemorrhagic CVD). 150 non-smokers, non-alcoholic subjects free from DM, renal disease, thyroid disease and liver disease were studied. Among them 120 were CVD cases and 30 were age & sex matched healthy control. Fasting (12 hr.) blood samples were collected from all subjects and in CVD cases samples were collected after 24 hr. of attack. Serum LP(a) concentration were measured in all samples. Mean serum LP(a) concentration in control, HCVD & ICVD were found to be 17.6 +/- 7.4 mg/dl, 31.9 +/- 15.6 mg/dl and 44.8 +/- 24.0 mg/dl respectively. Both HCVD & ICVD cases showed significantly higher level of serum LP(a) concentration compared to control. Moreover ICVD cases showed significantly higher level of serum LP(a) concentration compared to HCVD cases. The exquisite athero-thrombo-embolic potential of LP(a) explain its involvement with CVD but more with ICVD in comparison to HCVD; This finding apparently suggest the prospect of serum LP(a) concentration to be used as a promising laboratory maker to differentiate clinically the ICVD from HCVD following determination of cut-off value between ICVD & HCVD by broad based comprehensive study.

Studies on serum triglyceride level in patients with myocardial infarction.

Myocardial Infarction (MI) is the most common form of heart disease and the single most important cause of premature death in the developed and developing world. Unfortunately the incidence of the condition is increasing rapidly in many developing countries like Bangladesh. Effort should therefore be taken to minimize the risk factors of MI. Large scale randomized clinical trials have shown that lowering high triglyceride concentration mainly by drugs reduces the risk of cardiac events like MI. So the present work has been designed to see the serum triglyceride levels in normal healthy subjects, to compare serum triglyceride levels in patients with MI and those of healthy subjects and to evaluate the association of serum triglyceride in Bangladeshi MI patients. The present study was carried out in the Department of Biochemistry, BSMMU in collaboration with Department of Cardiology, BSMMU and NICVD, Dhaka during the period of July 2001 to December 2002. A total of 50 subjects were selected, Group A (30 subjects of control ) and Group B (20 subjects of test ). The mean level of serum triglyceride in control subjects were 117.07 +/- 32.41 mg/d1 and in test subjects were 176.87 +/- 37.15 mg/d1. So the present study showed that serum triglyceride level is significantly higher in patients with MI. From the present study, it is difficult to draw any definite conclusion but suggested that high serum triglyceride concentration is a cause of the incidence of MI.

Glycemic status in hyperthyroid subjects.

This was an observational case-control study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka jointly with the 'Thyroid and Endocrine Clinic' of the same institution during the period of January 2002 to December 2002. Sixty-five (65) newly diagnosed hyperthyroid patients between 20-60 years of age were studied, where forty-five (45) were Graves' disease and twenty (20) were TMNG (Toxic multinodular goiter) patients. Thyrotoxicosis was diagnosed by history, clinical examination and biochemical investigations- FT4, TSH, and Radioactive iodine uptake (RAIU) test. Thirty (30) age and sex matched healthy subjects were taken as control. The mean age was 33.02+/-9.24 years in Graves' disease and 37.55+/-9.49 years in TMNG. Female predominance observed in both the diseases. Glucose intolerance was found in 72.3% of thyrotoxic patients, which is much higher than European population. Our study showed Diabetes mellitus (DM) in 11% of Graves' disease patients. The incidence of DM in Graves' disease was slightly higher in our population. Incidence of DM in TMNG in our study was much lower (5%) than that of Graves' disease (11%) but the incidence of IGT (Impaired glucose tolerance) in TMNG was more (85%) in relation to Graves' disease (54%). Percentage of RAIU was more marked in Graves' disease than TMNG. There is a significant positive correlation (p<0.05) between plasma glucose and FT4 in Graves' disease. Glucose intolerance is frequently found in Thyrotoxic patients.

Characterisation of Jack fruit lectin.

Jack fruit (Artocarpus Heterophyllus) seed extract contains a lectin termed Jack fruit lectin (JFL) which possesses diversed biological properties. A detailed analysis of its properties has been lacking. The present investigation was initiated to study the detail properties of JFL. After extraction and purification on affigel galactosamine-agarose column, JFL was subjected to ND-PAGE. Several different charged species from ND-PAGE upon SDS-PAGE gave rise to two dissimilar trimeric subunit at 12.5 and 15.0 KDa and retain biological activity. It was possible to elute the subunit bands separately from polyacrylamide gel to investigate their biological activity. Each subunit was found to be retained the lectin activity. Agglutinating activity of smaller subunit was found to be more, may be due to the greater amount of the subunit. This also suggests that each unit of trimeric JFL have similar lectin activity.

Isolation modifies the behavioural response in rats.

Twenty-four male wister rats were reared from weaning either alone (isolation reared) or in groups of five (socially reared) for 6 weeks. Thereafter, the present study examined and compared the behaviour of isolation and socially reared rats in the test of social interaction, in the elevated plus-maze test of anxiety, in the open field behavior of exploration and locomotion activity, and the depressive behaviour in forced swim test. Under high light in unfamiliar conditions isolation reared rats spent significantly more time in aggressive interactions (P < 0.05) and high levels of aggressive behaviour compared to the socially reared rats (P < 0.05). Isolation reared rats had spent less time in the open arms than the socially reared rats in the maze test (P < 0.05). Isolation reared rats were more exploratory than the socially reared rats in the open field test and the defaecation scores were less compared to the socially reared controls (P < 0.05). Isolated rats spent less time immobile on the rats' forced swim test behaviour but the difference was not statistically significant. These findings suggest that isolation reared rats are nervous, aggressive and hyperactive animals in a novel field. It appears that isolation rearing in the early stages of life has modified a variety of behaviour in the adult rats, and the investigation of the pattern of behavioural changes in isolation reared rats may help to explore the environmental influences on the development of human psychopathology.