ABSTRACT
Background:Neonatal asphyxia is characterized by discrepancy of oxygen during perinatal period that can lead to severe hypoxic ischaemic organ damages followed by a fatal outcome including neurodegenerative diseases, mental retardation, and epilepsies. According to world health organization, four million neonatal deaths occurred each year due to birth asphyxia. Therefore, our study was designed to evaluate the status of serum glucose, calcium, electrolytes, and their correlation with the fetal risk factors associated with birth asphyxia. Methods:Neonates diagnosed with birth asphyxia were considered as “cases” while neonates birth either normal or by cesareanwith having no abnormality were considered as “control”. Demographics and possible risk factors of both the mother and neonate were noted. All asphyxiated neonates and controls were chosen to examine for serum glucose, calcium and electrolytes.Automated analyzers were used to estimate serum glucose, calcium, sodium and potassium.Results:We found thatthe mean serum glucose level was significantly lower in the asphyxiated neonates compared with controls, and consequently showed very strong positive correlation with the Apgar score. Furthermore, significant reduction levels were observed in serum calcium and sodium in the asphyxiated neonates, showing a linear correlation with the Apgar score. Moreover, higher serum potassium was detected in the asphyxiated neonates than in controls, showing a negative correlation with the Apgar score.Conclusions:We validated that the examined biochemicals of asphyxiated neonates was strongly correlated with the Apgar score. Our study reinforces for adequate clinicalevaluation and biochemical monitoring for early diagnosis to prevent adverse neurodevelopmental outcome
ABSTRACT
Background: Friedewald’s formula (FF) is used worldwide to calculate low-density lipoprotein cholesterol (LDL-chol). But it has several shortcomings: overestimation at lower triglyceride (TG) concentrations and underestimation at higher concentrations. In FF, TG to very low-density lipoprotein cholesterol (VLDL-chol) ratio (TG/VLDL-chol) is considered as constant, but practically it is not a fixed value. Recently, by analyzing lipid profiles in a large population, continuously adjustable values of TG/VLDL-chol were used to derive a novel method (NM) for the calculation of LDL-chol. Objective: The aim of this study was to evaluate the performance of the novel method compared with direct measurement and regression equation (RE) developed for Bangladeshi population. Materials and Methods: In this cross-sectional comparative study we used lipid profiles of 955 adult Bangladeshi subjects. Total cholesterol (TC), TG, HDL-chol and LDL-chol were measured by direct methods using automation. LDL-chol was also calculated by NM and RE. LDL-chol calculated by NM and RE were compared with measured LDL-chol by twotailed paired t test, Pearson’s correlation test, bias against measured LDL-chol by Bland-Altman test, accuracy within ±5% and ±12% of measured LDL-chol and by inter-rater agreements with measured LDL-chol at different cut-off values. Results: The mean values of LDL-chol were 110.7 ± 32.0 mg/dL for direct measurement, 111.9 ± 34.8 mg/dL for NM and 113.2 ± 31.7 mg/dL for RE. Mean values of calculated LDL-chol by both NM and RE differed from that of measured LDL-chol (p<0.01 for NM and p<0.0001 for RE). The correlation coefficients of calculated LDL-chol values with measured LDL-chol were 0.944 (p<0.0001) for NM and 0.945 (p<0.0001) for RE. Bland- Altman plots showed good agreement between calculated and measured LDL-chol. Accuracy within ±5% of measured LDL-chol was 49% for NM, 46% for RE and within ±12% of measured LDL-chol was 79% for both NM and RE. Inter-rater agreements (κ) between calculated and measured LDL-chol at LDL-chol <100 mg/dL, 100–130 mg/dL and >130 mg/dL were 0.816 vs 0.815, 0.637 vs 0.649 and 0.791 vs 0.791 for NM and RE respectively. Conclusion: This study reveals that NM and RE developed for Bangladeshi population have similar performance and can be used for the calculation of LDL-chol.
ABSTRACT
The most widely used investigation of renal function and GFR is the measurement of serum creatinine and creatinine clearance rate. This has been extremely popular in clinical medicine despite formidable difficulties associated with its quantification and interpretation. The main pathophysiological difficulties include variations in the rates of creatinine generation and its secretion by the renal tubules. Concentration of serum creatinine is now recognized as an unreliable measure of kidney function as it is affected by age, body weight, muscle mass, race and various medications. Several equations have been developed to improve the accuracy of serum creatinine level as a measure of GFR. The most widely used in adult populations are the Cockroft-Gault equation and the abbreviated Modification of Diet in Renal Disease (MDRD) equation. Even with these equations, measurement of GFR is difficult because the equations are less accurate with higher levels of kidney function and are affected by interlaboratory variation in measuring creatinine level. In the above perspective, cystatin C concentration has become a promising marker for kidney function in both native and transplanted kidneys. Because of the possible potentiality of cystatin C to be an emerging endogenous marker for quick and accurate assessment of renal function, we have decided to review elaborately on cystatin C as a marker of renal function and to review the sensitivity and specificity of cystatin C as an endogenous marker compared to serum creatinine. Results of our review study suggest that cystatin C is a better marker of renal function compared to serum creatinine and other endogenous markers irrespective of age, sex and clinical condition.
ABSTRACT
Background: Various formulas are available to estimate serum low-density lipoprotein (LDL) cholesterol. All of these are serum triglycerides (TG) dependent. But very recently de Cordova et al developed a simple formula (CF) to calculate LDL cholesterol without using serum TG and claimed it to be more accurate than Friedewald.s formula (FF). Objective: The objective of the present study was to evaluate the performance of the CF for the calculation of LDL cholesterol in a Bangladeshi population. Materials and Methods: Three hundred and sixty adult Bangladeshi subjects were purposively included in this study. Serum total cholesterol (TC), TG, high-density lipoprotein (HDL) cholesterol and LDL cholesterol were measured by direct automated methods. LDL cholesterol was also calculated by CF and FF. Results were expressed in conventional unit as mean ± SD and compared by two-tailed paired t test, bias against measured LDL cholesterol, Pearson's correlation coefficient (r), Passing & Bablok regression and accuracy within ±10% of the measured LDL cholesterol. Results: The mean values of directly measured LDL cholesterol, LDL cholesterol calculated by CF and FF were 117.7 ± 31.0, 111.8 ± 31.0 and 108.9 ± 39.7 mg/dL respectively. Bias of calculated LDL cholesterol against measured LDL cholesterol was -5.2% for CF and -9.6% for FF. The correlation coefficients of measured LDL cholesterol were 0.9796 (p<0.001) for CF and 0.9525 (p<0.001) for FF. Passing & Bablok regression yielded the equation y = 0.9938x - 6.2 for CF and y = 1.2774x - 40.9 for FF. Accuracy within ±10% of measured LDL cholesterol was 81% for CF and 49% for FF. Conclusion: This study revealed better performance of the de Cordova's formula than Friedewald's formula for approximate calculation of LDL cholesterol without using serum triglycerides.