Audit For Endocrine Assay in a Rural Tertiary Care Centre: Clinical Chemistry Lab Perspective

Endocrine disorders account for a significant amount of the global burden of disease. Hospital-based data provide substantial insight into the patterns of disease at community level to bridge the gaps in literature about the epidemiology of specific endocrine disorders, to aid in early diagnosis and identify priority areas for resource allocation. Methods: It was a cross sectional study conducted in the Department of Biochemistry, MGIMS, Sevagram. Secondary data analysis of Electronic Medical Records spanning over the years 2016 and 2017 was done. Results: A total of 1739 patients, 702 in 2016 and 1037 in 2017 were included in which substantially more investigations were ordered for females in OPD whereas in IPD, more tests were ordered for male patients. Conclusion: This study helps us gain an insight into the trends followed by some endocrine abnormalities in patients of a tertiary care centre in Central India. They throw light upon the burden of disease on the community that our focus during screening for early diagnosis as well as while formulating policies should be these hormones.

Antifilarial actions of green tea extract and a synthetic heterocyclic thiazolidine derivative, Im8 compound in experimental mouse model.

In spite of the advances in drug development and research against human lymphatic filariasis following the WHO mandate to address the disease-associated socioeconomic burden, diethylcarbamazine (DEC, N, N-diethyl-4-methyl-1-piperazine carboxamide) is the only available antifilarial drug to date. The major obstacle for further development of antifilarial drugs is the lack of validation of candidate drugs in the experimental animal models. Both, green tea extract and a synthetic heterocyclic thiazolidine derivative (Im8; 2-chloro-N-(4-phenylthiazol-2-yl), showed efficacy of antifilarial action in our earlier in vitro study and hence, they were screened in the present study for their antifilarial potential in the BALB/c mouse filariasis model. Mice were treated with 25 mg/kg dose of either Im8 or green tea extract or DEC or only with their respective vehicles. The untreated mice served as controls. Following insertion of the micropore chamber laden with microfilariae (Mf) of Brugia malayi, the drug or vehicle was administered s.c. in mice at 12 h intervals as 4 doses. After 12 h of administration of the last dose, the micropore chambers were removed to determine the action of the treatments as the loss of Mf motility. The green tea extract showed a significant antifilarial action and Im8 showed relatively less but significant antifilarial action as compared to the respective vehicle controls. Both the green tea extract and Im8 showed higher activity than that was exerted by DEC. These results revealed a greater efficacy of green tea and thiazolidine derivative, Im8 as the novelantifilarial agents in the experimental mouse model of filariasis.

Brugia malayi abundant larval transcript 2 protein treatment attenuates experimentally-induced colitis in mice.

Helminths are known to modulate host’s immunity by suppressing host protective pro-inflammatory responses. Such immunomodulatory effects have been experimentally shown to have therapeutic implications in immune mediated disorders. In the present study, we have explored a filarial protein i.e. Brugia malayi recombinant abundant larval transcript 2 (rBmALT2) for its therapeutic effect in dextran sodium sulfate (DSS) induced colitis in mouse model. The immunomodulatory activity of rBmALT-2 was initially confirmed by demonstrating that it suppressed the lipopolysaccharide (LPS) induced nitric oxide synthesis and down-regulated the expression of pro-inflammatory cytokines in vitro by peritoneal exudate cells of mice. Treatment with rBmALT2 reduced severity of colitis associated with significant reduction in weight loss, disease activity, colon damage, mucosal edema and histopathological score including myeloperoxidase activity in colon tissues. rBmALT2 was comparatively more effective in attenuation of colitis when used in the preventive mode than when used for curative purpose. The therapeutic effect of rBmALT2 was found to be associated with downregulation of IFN-γ, IL-6, IL-17 and upregulation of IL-10 cytokines. These results provide strong experimental evidence that BmALT2 could be a potential alternative therapeutic agent in colitis.

Targeting folate metabolism for therapeutic option: A bioinformatics approach.

Lymphatic filariasis, commonly called elephantiasis, poses a burden of estimated level of 5.09 million disability adjusted life year. Limitations of its sole drug, diethylcarbamazine (DEC) drive exploration of effective filarial target. A few plant extracts having polyphenolic ingredients and some synthetic compounds possess potential dihydrofolate reductase (DHFR) inhibitory effect. Here, we postulated a plausible link between folates and polyphenolics based on their common precursor in shikimate metabolism. Considering its implication in structural resemblance based antagonism, we have attempted to validate parasitic DHFR protein as a target. The bioinformatics approach, in the absence of crystal structure of the proposed target, used to authenticate and for virtual docking with suitable tested compounds, showed remarkably lower thermodynamic parameters as opposed to the positive control. A comparative docking analysis between human and Brugia malayi DHFR also showed effective binding parameters with lower inhibition constants of these ligands with parasitic target, but not with human counterpart highlighting safety and efficacy. This study suggests that DHFR could be a valid drug target for lymphatic filariasis, and further reveal that bioinformatics may be an effective tool in reverse pharmacological approach for drug design.

Antioxidant vitamin levels in sickle cell disorders.

BACKGROUND: Sickle cell disorder is a haemoglobinopathy prevalent in the Vidharbha region of Maharashtra, central India. With recent evidence of oxidative stress in sickle haemoglobinopathy, a possible deficiency of antioxidant vitamins was suspected. METHODS: We measured plasma vitamin E, vitamin C and beta-carotene levels in persons with heterozygous (n=80) and homozygous sickle cell state (n=20), and suitable healthy controls for these groups (n=100 and 66, respectively) in a community-based study in the villages near our institution. RESULTS: Subjects with heterozygous sickle cell trait had lower vitamin E levels than their respective controls (p < 0.05). Subjects with homozygous sickle cell disease had lower levels of all three vitamins (p < 0.05). Vitamins E and C levels showed a significant positive correlation in both forms of sickle cell disorder. CONCLUSION: Our findings suggest that there is depletion of the antioxidant vitamins, particularly in severe forms of sickle cell disorder. A trial of administration of therapeutic doses of vitamin E in this condition is warranted.

Small group discussion followed by presentation as a revision exercise at the end of a teaching module in biochemistry.

BACKGROUND: We evaluated the effect of student-dominated small group discussion followed by faculty-moderated presentation as a revision exercise after completion of a teaching module in biochemistry. We assessed the understanding of graduate medical students on the topic and the gain in retention of information, if any, after 15 days. METHODS: Small group discussions involving 11-12 students in each group were conducted on 12 application-oriented problems in 'amino acid metabolism'. A group leader among the students helped to conduct the discussions. While two-thirds of the problems were taken up after the discussion during faculty- or student-moderated interactive presentations, the remaining were not. The effects on low-, medium- and high achievers were evaluated by a pre-test and post-test with multiple choice questions immediately after the session. A subjective feedback was also obtained. To test short-term memory, a post-test with the same multiple choice questions was conducted after 15 days. RESULTS: The exercise was effective and equally beneficial for low-, medium- and high achievers. The gain was maximum when faculty moderated the presentation session. The students' retention of their gain after 15 days was complete. All the students wanted more such sessions in future. CONCLUSION: Student-dominated small group discussion followed by a faculty-moderated presentation is an effective, revision exercise for undergraduate medical students.