Study of Serum Sialic Acid and Copper as Inflammatory Markers in Type 2 Diabetes Mellitus.

The study aims to understand the relationship between increased serum levels of acute- phase reactants like Sialic Acid (SA) and transitional metals like Copper (Cu) which are indicated to be associated with the etiology and pathogenesis of type 2 diabetes mellitus (DM) and its various chronic complications. Serum SA and Cu levels, measured colorimetrically using Ehrilch’s reagent and Atomic Absorption Spectrophotometer (AAS) respectively among 30 cases each of type 2 DM with and without long-term complications, were significantly higher in all the cases compared to controls. The values are even higher in cases with complications, compared to diabetics without complications. Serum lipid profile was significantly altered in both the experimental groups. Serum SA and Cu levels are positively correlated to duration and degree of impaired glycemic status and altered lipid profile in type 2 DM. Measurement of these new serum markers can explain the inflammatory process, implicated towards the development of diabetic complications like cardiovascular diseases and microangiopathies thereby helping in early medical intervention.

A study on asymptomatic bacteriuria in pregnancy: prevalence, etiology and comparison of screening methods.

Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. Methods: Clean catch mid-stream urine were collected from 250 pregnant women aged between 18-45 years attending antenatal clinic, for a period of one year (November 2008-2009). Screening tests such as gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test were done. Identification of organisms and antibiotic sensitivity tests were performed as per standard methods. Results: Out of the 250 pregnant women, 21 (8.4%) had significant bacteriuria. High percentage of asymptomatic bacteriuria was seen in 2nd trimester (42.86%) and in primigravidas (52.38%). E. coli (57.14%) was the most common organism. Among screening tests gram staining of uncentrifuged urine had a sensitivity of 85.71%. Nitrite and leukocyte esterase tests alone showed sensitivity of 71.42%. However, the combination of these two tests, either tests positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively. Conclusion: Asymptomatic bacteriuria in pregnancy can be identified by simple and combined rapid screening methods and urine culture along with antibiogram so that early treatment can be started thereby preventing complications.

Study of Cardiovascular Autonomic Dysfunction in Type II Diabetes Mellitus.

Autonomic neuropathy is a common complication of diabetes mellitus which may affect major systems like cardiovascular system that may cause early death in diabetics. In our study attempt was made to asses different cardiovascular autonomic function parameters like change of blood pressure from supine to standing posture (postural BP changes) and ratio of longest and shortest R-R interval during deep expiration and inspiration respectively (E/I ratio) on ECG in type 2 diabetics and age sex matched non diabetic controls. Level of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1C) were also measured in the same subjects. Diabetics were subdivided into <5 years and >5 years groups. Findings were compared between diabetics and the controls and also between the subgroups of diabetics. Correlation between glycaemic control , duration of disease and autonomic function parameters were tested. We found, a significant difference in postural BP changes and E/I ratios between diabetics and the controls, no significant correlation could be found out between glycaemic control or duration of disease and autonomic function parameters. Therefore, our study concludes that diabetes may lead to autonomic dysfunction that may cause postural hypotension and altered E/I ratio irrespective of the duration of disease and glycemic control.

Association of Obesity and Leptin with Insulin Resistance in Type 2 Diabetes Mellitus in Indian Population.

Obesity and diabetes mellitus are two modern epidemics. But their interrelationship is debated. Here we explored the probable association among obesity, leptin and insulin resistance in type 2 diabetes mellitus. 60 recent onset (<5 years) diabetics and age-sex matched 33 non diabetic controls were assessed for physical and chemical parameters like Body Mass Index, abdominal circumference, waist/hip ratio, fasting blood glucose, insulin and leptin. Degree of insulin resistance was calculated by HOMAIR method (Homeostatic Model Assessment). All the physical parameters showed positive correlation with leptin and the HOMA-IR score, strength of association being highest between insulin resistance and abdominal circumference. Leptin and insulin resistance showed no correlation. Findings were lower in controls. Study concluded that, obesity mainly central type might be responsible for insulin resistance in type 2 diabetes mellitus where as leptin, a potential marker for obesity, may not. This perhaps points towards the multifactorial causation of insulin resistance in type 2 diabetes mellitus.

LDL Susceptibility to Oxidative Stress in Smokers.

In 30 cigarette smokers and in 30 sex and age matched nonsmoker controls, susceptibility of LDL to oxidative stress following incubation with copper sulphate (1mM) was measured in terms of thiobarbituric acid reactive substance. Susceptibility of LDL to oxidation in smokers was found to be 0.514131±0.468231picomol MDA/μg protein/hr. LDL susceptibility to oxidation in non-smokers was found to be 0.711726 ± 0.447324picomol MDA/μg protein/hr. These two values were not statistically different (p=0.1) by unpaired T test. This study therefore suggests that cigarette smoke does not increase LDL susceptibility to oxidation.