Cross-sectional study of glycosylated haemoglobin in type 2 diabetes mellitus patients of South Indian origin.

Background: Prevalence of Type 2 Diabetes Mellitus in Indian population is on rise and is leading to significant morbidity and mortality. The revised ADA guidelines since 2010 have suggested glycated haemoglobin (HbA1c) as a diagnostic test for Type 2 diabetes. HbA1c level is having geographic and ethnic variability independent of glycaemic status and this has not been extensively studied in many regions. Objective: To study the characteristics of HbA1C in the South Indian population and to determine the cut off value for HbA1C in diagnosing Diabetes in them. Methods: This is a hospital based observational study conducted at a Tertiary care centre in North Kerala. Patients with age ≥30yrs with Fasting Plasma Glucose (FPG) ≥ 100 or Random Plasma Glucose (RPG) ≥ 200 with symptoms of hyperglycaemia with no previous history of anti diabetic treatment were selected for the study. A preset questionnaire was used to collect the data which was later analysed using relevant statistical techniques. Results: Out of the consecutive diabetic patients attending medicine OPD 99 newly detected diabetics/prediabetics who were not under any anti diabetic medications were studied. New onset diabetes/prediabetes patients showed a mean HbA1c of 8.26(SD=2.31). There was no significant correlation of HbA1c values with age, sex and duration of diabetes in the study population. The HbA1c values also had no significant correlation with systolic blood pressure, total cholesterol values or triglyceride levels. However it was significantly related to Fasting plasma glucose, Post prandial plasma glucose and serum LDL cholesterol values. In newly detected diabetic patients (with FPG≥126 taken as gold standard) ROC analysis determined a HbA1c cut off at 6.45% (AUC=0.76, sensitivity=79%, specificity=60%). Conclusion: The study provides a reliable cutoff of glycated haemoglobin (6.45%) among South Indian population which is in accordance with the ADA recommendations.

Klippel-Trenaunay Syndrome and Gestational Trophoblastic Neoplasm.

Background: Klippel-Trenaunay syndrome is a non-heritable venous malformation with bone and soft tissue hypertrophy and cutaneous nevi. Case characteristics: Neonate with Klippel Trenaunay syndrome born to a mother with past history of Gestational trophoblastic neoplasm. Observation: Antenatally, a fetal vascular malformation was identified ultrasonologically at 29 weeks gestation. Acute myeloid leukemia was diagnosed in mother at 33 weeks gestation. Message: A rare association of Klippel Trenaunay syndrome and gestational trophoblastic neoplasm with the possible role of either hyperglycosylated Human Chorionic Gonadotropin or chemotherapy as a link is highlighted.

Evaluation of product analogues for purification of penicillinase by affinity chromatography.

Among different matrices prepared, ampicilloic acid-polymer matrix offered 86.7% adsorption, 95% elution and 82.4% overall recovery of penicillinase. The structure of both the side chain and penicilloic or cephalosporoic acid moieties contribute to the affinity interactions.

Production of extracellular acidic lipase by Rhizopus arrhizus as a function of culture conditions.

Thermophilic strain of Rhizopus arrhizus accumulates an acidic lipase in culture fluid when grown in a medium containing ground nut oil, milk powder and inorganic salts. Addition of 2.0% ground nut oil yielded the highest productivity of enzyme. Soyabean meal and arabinose were found to be the best nitrogen and carbon sources for enzyme production respectively. Addition of metal ions such as MnCl2, SnCl2 and CaCl2 increased the enzyme productivity by 4 fold. The enzyme productivity in the fermenter was much higher (310 U/ml) than in shake-flask (180 U/ml). Crude lipase preparation showed pH and temperature activity optima at 3.5 and 45 degrees C respectively. The enzyme is thermostable and highly active in hydrolysing triglycerides and failed to hydrolyse-methyl esters of caprylate and palmitate.

Cephalosporin acylases: enzyme production, structure and application in the production of 7-ACA.

Cephalosporin acylases have application in the production of 7-aminocephalosporanic acid which forms a key raw material for the preparation of semisynthetic injectable cephalosporins. The enzymes are of industrial importance and hyperproducing genetically engineered strains have been constructed. Different aspects of these enzymes such as subunit structure, post translational modification, primary structure, substrate specificity and their importance in pharmaceutical industry are discussed.

Immobilization of penicillin G acylase onto ion exchange and hydrophobic resins.

Penicillin G acylase was immobilized on numerous cation exchange resins and hydrophobic adsorbents. Amberlite XAD-7 was the matrix of choice among the matrices studied for the immobilization of enzyme. Binding of 96.8% and expression of 82.6% of the penicillin G acylase was achieved on XAD-7. Penicillin G acylase immobilised on XAD-7 was used for 80 cycles for the production of 6-PA in a stirred tank reactor.

Bactericidal power of neutrophils in protein calorie malnutrition.

The present study was undertaken to compare the disturbance in bactericidal power of neutrophils in 25 children having protein caloric malnutrition age and sex matched healthy control subjects. There was a highly significant reduction in the percentage of bacteria killed during incubation in children having PCM as compared to healthy control. A direct relationship existed between total serum proteins and bactericidal activity of neutrophils in children having PCM. The impaired bactericidal power of neutrophils can be attributed to impaired synthesis of lysosomal enzymes, glycolytic activity of neutrophils in children having PCM. The exact mechanisms still remain to be elucidated. Decreased bactericidal activity of neutrophils may be one of the mechanisms responsible for infection.

A study of incidence of Australia antigen and derangements in liver function tests in leprosy.

The present study was conducted in 50 patients of various subtypes of leprosy (Lepromatous, Tuberculoid, Borderline borderline) and 25 healthy control, for detection of Australia antigen and various liver function tests (serum protein, cholesterol, alkaline phosphates, SGOT, SGPT, bilirubin and liver biopsy) to see incidence of Australia Antigen and derangement in liver function. It was concluded that incidence of Australia antigen in study and control group was zero. Total serum protein and serum globulin was increased in lepromatous leprosy. A/G ratio was reversed in 34.3% and 50% in lepromatous and tuberculoid leprosy respectively. Granulomatous hepatitis was seen in 66.66% and 50% cases of lepromatous and tuberculoid leprosy respectively. No relationships was established between hepatic lesion, Australia antigen and liver function test.