Hypomagnesemia � An overlooked parameter in type 2 diabetes mellitus

Background: Diabetes Mellitus refers to a group of common metabolic disorders that share the phenotype of Hyperglycemia. It is the leading cause of morbidity and mortality throughout the world with an estimated worldwide prevalence of 439 million by 2030 and 19% of world抯 DM patients are Indians. Magnesium is an important co-factor for various enzymes involved in Insulin secretion and is involved in sodium-potassium ATPase pump. 25%-38% of Type 2 DM patients had Hypomagnesemia, which has also contributed in developing microvascular complications such as Diabetic Retinopathy (DR) and Diabetic Nephropathy (DN). Various studies have suggested that Magnesium supplementation in Type 2 DM patients with Hypomagnesemia have shown beneficial effects on insulin sensitivity and glucose metabolism. Aim and objectives: To study the prevalence of Hypomagnesemia in Type 2 DM patients and to study the association of Hypomagnesemia with microvascular complications such as DR and DN. Materials and methods: It is a hospital based Observational study carried out in 2022 for a period of 1 year including 60 patients fulfilling the ADA criteria for diagnosing T2DM and patients with Diabetic Retinopathy and Diabetic Nephropathy, and excluding patients with Malabsorption, Chronic diarrhoea, Renal Failure on diuretic therapy, Sepsis, Pancreatitis. Serum Magnesium levels of 1.6 mg/dl � 2.6 mg/dl is considered as normal range. Serum Magnesium were measured using Xylidyl blue colorimetric method. Results: The Mean age of the patients in our study was 55.89 years. Among 60 patients diagnosed with Diabetes Mellitus, 42 patients had Hypomagnesemia, 18 patients had Normomagnesemia (p- value: <0.0001). Patients with an HbA1c levels > 7% had Hypomagnesemia when to compared to patients with HbA1c <7% with a significant p value of 0.009. Hypomagnesemia was also associated with Diabetic Retinopathy and Diabetic Nephropathy with a significant p-value of 0.013 and 0.009 respectively. Conclusion: In our study, it has shown that patients with uncontrolled T2DM had Hypomagnesemia, which is also associated with micro-vascular complications of T2DM such as DR and DN.

USE OF GLYCATED HEMOGLOBIN (HBA1C) TESTING IN THE DIAGNOSIS OF DIABETES: A SYSTEMATIC REVIEW

Early detection of diabetes is of great clinical importance in order to prevent or delay its micro- and macrovascular complications. That is why, the largest diabetes associations continue their search for the most accurate, sensitive and speci?c, reliable and reproducible diagnostic assay.ADA, the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes have recommended to consider the use of glycated hemoglobin (HbA1c) testing in the diagnosis of diabetes

A brazilian nationwide multicenter study on deficiency of deaminase-2 (DADA2)

Abstract Introduction The deficiency of ADA2 (DADA2) is a rare autoinflammatory disease provoked by mutations in the ADA2 gene inherited in a recessive fashion. Up to this moment there is no consensus for the treatment of DADA2 and anti-TNF is the therapy of choice for chronic management whereas bone marrow transplantation is considered for refractory or severe phenotypes. Data from Brazil is scarce and this multicentric study reports 18 patients with DADA2 from Brazil. Patients and methods This is a multicentric study proposed by the Center for Rare and Immunological Disorders of the Hospital 9 de Julho - DASA, São Paulo - Brazil. Patients of any age with a confirmed diagnosis of DADA2 were eligible for this project and data on clinical, laboratory, genetics and treatment were collected. Results Eighteen patients from 10 different centers are reported here. All patients had disease onset at the pediatric age (median of 5 years) and most of them from the state of São Paulo. Vasculopathy with recurrent stroke was the most common phenotype but atypical phenotypes compatible with ALPS-like and Common Variable Immunodeficiency (CVID) was also found. All patients carried pathogenic mutations in the ADA2 gene. Acute management of vasculitis was not satisfactory with steroids in many patients and all those who used anti-TNF had favorable responses. Conclusion The low number of patients diagnosed with DADA2 in Brazil reinforces the need for disease awareness for this condition. Moreover, the absence of guidelines for diagnosis and management is also necessary (t).

Novel biomarkers for Diagnosis of Pulmonary Tuberculosis and Tuberculous Pleural Effusion

Background: The present study aimed to evaluate the importance of serum, pleural adenosine deaminase (ADA), and Gene Xpert in Diagnosis of TB and TB Pleural Effusion (TB-PLE.).Material & Methods:The study was done with 75 TB cases, 50 cases of them were diagnosed as Pulmonary TB and 25 cases as TB pleural effusion, collecting also 50 non-TB pleural effusion, Malignant and acute bacterial infection comprise 21 and 29 cases respectively. Cases with transudative pleural effusion were excluded from the study. Finally, 75 were healthy control group.Results:There was a highly significant difference between the mean age of TB-PE Patients and Patients non-TB-PLE (P-value <0.001), while there was a non-significant difference with patients with P-TB (P-value >0.05). Mean of Serum ADA level were highest 53.16 U/L in TB-PE cases, shown to be statistically significant when compared to 43.2 U/L in P-TB and 25.4 U/L in non TBpleural effusion. With p-value of 0.02 and 0.001respectively.Conclusions:We concluded that GeneXpert can be a useful diagnostic method in patients with suspected pulmonary tuberculosis. Serum and pleural fluid ADA level is a very helpful test to rule out a TB and can help differentiate tubercular etiology from non-tubercular.

Síndrome de Sweet por tuberculosis peritoneal: reporte de caso / Sweet's Syndrome due to peritoneal tuberculosis: Case report

Resumen La tuberculosis (TBC) peritoneal es una entidad poco frecuente y representa un 25 %-50 % de los casos de tuberculosis abdominal, y 0,1 %-0,7 % de todos los casos de tuberculosis. La mortalidad alcanza un 35 % cuando hay un retraso en el tratamiento, y un 73 % en pacientes con cirrosis. Además, tiene un gran espectro clínico, por lo que su diagnóstico diferencial abarca a nivel clínico patologías como cirrosis, malignidad, síndrome nefrótico, desnutrición; a nivel imagenológico enfermedad metastásica peritoneal, carcinomatosis de origen gástrico, pancreático, vesical, ovárico, colónico y enfermedades infecciosas como actinomicosis, coccidioidomicosis, histoplasmosis o micobacterias no tuberculosas. El diagnóstico se apoya inicialmente con química sanguínea, función hepática y renal, ultrasonido, tomografía computarizada (TC), paracentesis con citoquímico de líquido peritoneal, medición de adenosina-desaminasa (ADA) y reacción en cadena de polimerasa (PCR); no obstante, la laparoscopia con biopsia peritoneal y confirmación patológica o microbiológica siguen siendo el estándar de oro. Se han descrito casos de falsos negativos de la prueba ADA en situaciones de inmunosupresión o uso de antituberculosos. Se ha planteado el seguimiento de la actividad de la enfermedad midiendo los niveles de antígeno del cáncer 125 (CA-125). A continuación, presentamos un caso inusual de un paciente con TBC peritoneal con un síndrome de Sweet secundario, en quien inicialmente el reporte para ADA fue negativo, posiblemente debido a la administración de meropenem y en quien, además, se hizo el seguimiento de la actividad de la enfermedad con CA-125. Son muy excepcionales los reportes de falsos negativos de ADA y Sweet secundario a tuberculosis, por lo cual aportamos a la literatura con el reporte de nuestro caso.

Abstract Peritoneal tuberculosis is a rare disease that accounts for 25-50% of abdominal tuberculosis cases and 0.1-0.7% of all cases of tuberculosis. Mortality is 35% when treatment is delayed, and 73% in patients with cirrhosis. It also has a wide clinical spectrum, so its differential diagnosis covers conditions such as cirrhosis, malignancy, nephrotic syndrome, and malnutrition. Moreover, imaging studies may reveal peritoneal metastases; carcinomatosis of gastric, pancreatic, bladder, ovarian, colonic origin; and infectious diseases such as actinomycosis, coccidioidomycosis, histoplasmosis or non-tuberculous mycobacteria. Diagnosis is initially supported by blood chemistry, liver and renal function tests, ultrasound, CT scans, paracentesis with peritoneal fluid cytochemistry, and ADA and PCR measurement. The gold standard is laparoscopy with peritoneal biopsy and pathological or microbiological confirmation. Cases of false negatives of the ADA test have been described in immunosuppression or use of antituberculosis drugs. Monitoring of disease activity by measuring CA-125 levels has been considered. The following is the report of an unusual case of peritoneal TB with secondary Sweet's syndrome, in which the ADA report was initially negative, possibly due to meropenem administration, and in whom disease activity was monitored through Ca125. False negative reports of ADA and Sweet's secondary to TB are very rare, so this case contributes to the literature on these conditions.

Critical Cerebrospinal Fluid Adenosine Deaminase Activity In Tubercular Meningitis

Background:Tuberculosis of the central nervous system accounts for ~5% of extrapulmonary cases in the United States. It is seen most often in young children but also develops in adults, especially those infected with HIV. If unrecognized, tuberculous meningitis is uniformly fatal. This disease responds to chemotherapy.Cerebrospinal fluid (CSF) evaluation is the single most important aspect of laboratory diagnosis of meningitis. Basic studies of CSF that should be performed in meningitis include measurement of pressure, cell count and differential count, estimation of glucose and protein levels, Gram's stain and culture.Objectives:To evaluate the diagnostic significance of CSF adenosine deaminase (ADA) activity in tuberculous meningitis.Material & Methods:70 Tubercular Meningitis patients who were admitted in Department of Medicine, Victoria hospital were included. The study was approved by the Ethical Committee of Bangalore Medical College and Research Institute, Bangalore. Patients were selected after fulfilling the following inclusion and exclusion criteria.Results:The mean age of the 70 patients studied was 39.82+16.48 years. The youngest patient was 18 years old and oldestpatient was 70 years.The mean value of ADA activity in tubercular meningitis was 18.07±8.03IU/L. Cut-off value of ADA in our study was 10 IU/. The result was statistically significant with a p value<0.001. Conclusion: The test for ADA in CSF is simple and can be carried out in a central laboratory with a rapid diagnosis, thus reducing unwarranted or harmful therapy for patients.Elevated CSF-ADA level helpsin differentiating tubercular from non-tubercular meningitis.

Biochemical characterization of adenosine deaminase (CD26 EC 3. 5. 4. 4) activity in human lymphocyte-rich peripheral blood mononuclear cells

The conversion of adenosine to inosine is catalyzed by adenosine deaminase (ADA) (EC 3.5.4.4), which has two isoforms in humans (ADA1 and ADA2) and belongs to the zinc-dependent hydrolase family. ADA modulates lymphocyte function and differentiation, and regulates inflammatory and immune responses. This study investigated ADA activity in lymphocyte-rich peripheral blood mononuclear cells (PBMCs) in the absence of disease. The viability of lymphocyte-rich PBMCs isolated from humans and kept in 0.9% saline solution at 4-8°C was analyzed over 20 h. The incubation time and biochemical properties of the enzyme, such as its Michaelis-Menten constant (Km) and maximum velocity (Vmax), were characterized through the liberation of ammonia from the adenosine substrate. Additionally, the presence of ADA protein on the lymphocyte surface was determined by flow cytometry using an anti-CD26 monoclonal human antibody, and the PBMCs showed long-term viability after 20 h. The ADA enzymatic activity was linear from 15 to 120 min of incubation, from 2.5 to 12.5 µg of protein, and pH 6.0 to 7.4. The Km and Vmax values were 0.103±0.051 mM and 0.025±0.001 nmol NH3·mg-1·s-1, respectively. Zinc and erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA) inhibited enzymatic activity, and substrate preference was given to adenosine over 2′-deoxyadenosine and guanosine. The present study provides the biochemical characterization of ADA in human lymphocyte-rich PBMCs, and indicates the appropriate conditions for enzyme activity quantification.

Hyperuricemia and Serum ADA Levels in Psoriasis and their Correlation to Severity of Disease

Introduction: Psoriasis is a chronic inflammatoryautoimmune disease characterized by hyperproliferation ofkeratinocytes with multifactorial pathogenesis includinggenetic, and environmental factors. The aim of this study wasto evaluate serum ADA, SUA, and ESR in psoriatic patientsand their correlations with PASI score.Material and methods: Our study was a case–control study.The sample size was calculated using the Cochran formulaand 50 patients of psoriasis who attended the out patient clinicat SMHS and Government medical college, srinagar wereincluded in the study. These patients were divided accordingto PASI scores into three groups (mild, moderate, and severe).PASI score <10 defined psoriasis as mild, between 10 and 20as moderate, and >20 as severe. A group of 50 healthy subjectsof matched age and sex were included as a control group whowere taken from amongst volunteering hospital staff andrelatives.Results: This study included 50 psoriatic patients classifiedaccording to PASI score into mild, moderate, and severepsoriatic group and 50 age and sex matched controls. Outof these four patients had mild psoriasis, twelve patients hadmoderate psoriasis and thirty four patients had severe psoriasisaccording to PASI. Fifty healthy subjects were includedas a control group. There were no statistically significantdifferences of age and sex between different patients and thecontrol group.Conclusion: ESR, Serum Uric Acid and serum adenosinedeaminase levels are significantly raised in patients withpsoriasis. However there was no association with severity ofdisease in these patients, however, larger studies are neededto elucidate the mechanism and whether this hyperuricemiapredisposes these patients to gout and increased risk ofcardiovascular disease.

To Determine the Usefulness of ADA Risk Score to Predict T2dm/Pre Diabetes in South Indian Rural Population

Introduction: Diabetes mellitus – so called “epidemic diseaseof the century” has become a serious public health issue. Ourstudy was aimed to determine the effectiveness of ADA riskscoring in the south Indian rural population in predicting prediabetic and diabetic among the study population.Material and methods: This was an observational study todetermine the the effectiveness of ADA risk scoring in southIndian rural population in predicting pre diabetic and diabeticamong study population. In the present study of selectedsubjects were assessed for ADA scoring and HbA1c was done.Results: In the present study, the mean HbA1C of patientwith score less than 5 was 4.7 ± 0.1, mean HbA1C of patientwith score more than or equal to 5 was 6.07 ± 0.02.which wassignificant with a P value of <0.01.Conclusion: In our study we conclude that ADA risk scoringis a good indicator for identifying pre diabetes and type 2diabetes mellitus in our population.

Clinical study of meningitis in children and role of adenosine deaminase in differentiating tubercular from non-tubercular meningitis

Background: In diseases where cell mediated immunity plays an important role like in tuberculosis, CSF (Cerebrospinal fluid) adenosine deaminase (ADA) activity is increased. Hence, this testing is done especially among children with suspected tubercular meningitis. The objective of this was to study role of Adenosine Deaminase in differentiating tubercular from non-tubercular meningitis.Methods: This was a hospital based cross sectional study was carried out among 50 children of proven meningitis for a period of two years. CSF ADA levels were done for all cases. They were divided into tubercular meningitis and non-tubercular meningitis group and compared.Results: Incidence of tuberculous meningitis (TBM) was found high in the age group 5-8 years. Male:female ratio was 2.3:1. Fever was present in all cases followed by vomiting and neck rigidity. CSF AFB was positive in 3 cases (6%). Neuroimaging was done in all cases in which 3 patients had basal exudate in which 2 patients had TBM and 1 patient was Non-TBM. 3 patients had hydrocephalus in MRI in which 2 had TBM diagnosed and 1 had non-TBM. As per ADA levels, 10 were diagnosed as TBM out of which 8 patients had ADA level ?10 IU/L and 2 had ADA level <10 IU/L which was missed by ADA and later confirmed by other modalities.Conclusions: It was concluded that if ADA level in CSF is ?10IU/l the diagnosis of TBM should be considered.

An observational study to compare adenosine deaminase level among diabetes patients

Background: Obesity is a complex disorder that involves some degree of over-consumption1 coupled with a metabolic derangement. As ADA has been putatively associated with inflammation, and adipose tissue inflammation is the hallmark of insulin resistance in obese T2DM patients. This study attempted to compare serum ADA in T2DM subjects.Methods: This observational cross-sectional study was conducted in the Department of Biochemistry at MGM Medical College and MY Hospital. All the patients and controls were clinically examined, and routine biochemical tests were analyzed for all subjects. ANOVA has been applied to assess the variance between groups.Results: Mean age of controls was 56.91 years where as mean age in the group of a subject with Obesity with diabetes was 40.91 years and with Obesity without diabetes was 48.10 years. ADA level was more among diabetes patients having obesity than diabetes patients having no obesity and controls.Conclusions: This is very much evident through this study that ADA may be treated as prognostic predictor of diabetes either linked to obesity or not, though more studies are warranted in same direction to make this finding conclusive and acceptable biochemical evidence.

Transformative hyaluronic acid-based active targeting supramolecular nanoplatform improves long circulation and enhances cellular uptake in cancer therapy

Hyaluronic acid (HA) is a natural ligand of tumor-targeted drug delivery systems (DDS) due to the relevant CD44 receptor overexpressed on tumor cell membranes. However, other HA receptors (HARE and LYVE-1) are also overexpressing in the reticuloendothelial system (RES). Therefore, polyethylene glycol (PEG) modification of HA-based DDS is necessary to reduce RES capture. Unfortunately, pegylation remarkably inhibits tumor cellular uptake and endosomal escapement, significantly compromising the antitumor efficacy. Herein, we developed a Dox-loaded HA-based transformable supramolecular nanoplatform (Dox/HCVBP) to overcome this dilemma. Dox/HCVBP contains a tumor extracellular acidity-sensitive detachable PEG shell achieved by a benzoic imine linkage. The and investigations further demonstrated that Dox/HCVBP could be in a "stealth" state at blood stream for a long circulation time due to the buried HA ligands and the minimized nonspecific interaction by PEG shell. However, it could transform into a "recognition" state under the tumor acidic microenvironment for efficient tumor cellular uptake due to the direct exposure of active targeting ligand HA following PEG shell detachment. Such a transformative concept provides a promising strategy to resolve the dilemma of natural ligand-based DDS with conflicting two processes of tumor cellular uptake and nonspecific biodistribution.

A study to construct three prokaryotic expression vectors and its expression in adenosine deaminase / 国际检验医学杂志

Objective To express adenosine deaminase protein by molecular cloning technique.MethodsTotal RNA was extracted from human leukocytes and the cDNA was obtained by reverse transcription.Whereupon the cDNA was used as a template to amplify adenosine deaminase gene by polymerase chain reaction (PCR) and then integrated it into three prokaryotic plasmids pET-28 b, pET-32 a (+) and pHSIE.The plasmid with the correct sequencing was transformed into E.coli BL21 (DE3) by CaCl2 method for the protein expression.The expression activity of these fusion proteins were detected by Western-blot and SDS-PAGE, with the optimized expression conditions.Results Complete fusion of target gene and three prokaryotic plasmids was observed through sequencing.The expressed and accurate ADA protein was identified by Westernblot and SDS-PAGE.The optimal expression conditions were observed:the protein expression would be induced with 0.4 mmol/L IPTG and incubated at 16℃for 24 hours.Conclusion The prokaryotic vectors of adenosine deaminase (BL21+pET-28 b+ADA, BL21+pET-32 a+ADA, BL21+pHSIE+ADA) were successfully constructed and efficiently expressed.

IoT-based measurement system for classifying cow behavior from tri-axial accelerometer / Sistema de medição baseado em IoT para classificar o comportamento de vacas através de acelerômetro tri-axial

ABSTRACT: A cow behavior monitoring system based on the Internet of Things (IoT) has been designed and implemented using tri-axial accelerometer, MSP430 microcontroller, wireless radio frequency (RF) module, and a laptop. The implemented system measured cow movement behavior and transmitted acceleration data to the laptop through the wireless RF module. Results were displayed on the laptop in a 2D graph, through which behavior patterns of cows were predicted. The measured data from the system were analyzed using the Multi-Back Propagation-Adaptive Boosting algorithm to determine the specific behavioral state of cows. The developed system can be used to increase classification performance of cow behavior by detecting acceleration data. Accuracy exceeded 90% for all the classified behavior categories, and the specificity of normal walking reached 96.98%. The sensitivity was good for all behavior patterns except standing up and lying down, with a maximum of 87.23% for standing. Overall, the IoT-based measurement system provides accurate and remote measurement of cow behavior, and the ensemble classification algorithm can effectively recognize various behavior patterns in dairy cows. Future research will improve the classification algorithm parameters and increase the number of enrolled cows. Once the functionality and reliability of the system have been confirmed on a large scale, commercialization may become possible.

RESUMO: Um sistema de monitoramento de comportamento de vacas baseado na Internet das Coisas (IoT) foi projetado e implementado através do uso de acelerômetro tri-axial, Microcontrolador MSP430, módulo de rádio, frequência sem fio (RF), e um portátil. O sistema implementado mediu o comportamento do movimento da vaca e transmitiu dados de aceleração ao portátil através do módulo RF sem fio. Os resultados foram exibidos no portátil em um gráfico 2D, através do qual os padrões de comportamento das vacas foram previstos. Os dados medidos do sistema foram analisados usando o Multi-retropropagação-Adaptativa algoritmo de Boosting para determinar o estado comportamental específico das vacas. O sistema desenvolvido pode ser usado para aumentar a classificação de desempenho de vaca comportamento através da detecção de aceleração de dados. A precisão excedeu 90% de todas as categorias de classificação de comportamento e a especificidade do andar normal atingiu 96.98%. A sensibilidade foi boa para todos os padrões de comportamento, exceto em pé e deitada, com um máximo de 87.23% para ficar de pé. No geral, o sistema baseado em IoT fornece medição precisa e remota do comportamento da vaca, e o algoritmo de conjunto de classificação pode efetivamente reconhecer vários padrões de comportamento em vacas leiteiras. Pesquisas futuras irão melhorar os parâmetros do algoritmo de classificação e aumentar a quantidade de vacas matriculadas. Uma vez que a funcionalidade e confiabilidade do sistema foram confirmadas em larga escala, a comercialização pode se tornar possível.

The advantage of PCR for MTB in comparison to ADA in diagnosing tubercular pleural effusion

Background: Tuberculosis continues to be an important health problem globally. The bacteriological confirmation of diagnosis in extrapulmonary tuberculosis patients is more difficult because most of the cases of extrapulmonary tuberculosis are paucibacillary in nature. In this study we have compared the pleural fluid ADA levels with PCR for MTB in pleural fluid to confirm the diagnosis of tuberculosis in the pleural fluid.Methods: The study was done over two years and a total of 106 patients with a clinico-radiological diagnosis of pleural effusion were enrolled for the study. The pleural fluid was aspirated and examined for total cell count, differential cell count, protein, sugar, ADA and PCR for MTB.A CT Thorax was done in all the 106 patients of pleural effusion and underlying consolidation along with pleural effusion was found in 60 patients.Results: The pleural fluid was exudative in nature in all the patients. 90 patients (84.9%) had lymphocyte predominant pleural effusion while 16 patients (15.1%) had neutrophil predominant pleural effusion. The overall sensitivity of ADA in all the cases of pleural effusion was 85.2% while the overall sensitivity of PCR for MTB in all the cases of pleural effusion was 51.1%. However, in the 60 patients of pleural effusion with underlying lung consolidation, the overall sensitivity of ADA was 69.1% while the overall sensitivity of PCR for MTB was 92.8% for diagnosing tubercular pleural effusion.Conclusions: PCR for MTB is a useful test along with ADA for diagnosing tubercular pleural effusion. PCR for MTB is especially useful in the diagnosis of tubercular pleural effusion in patients with underlying lung consolidation.

Pharmacokinetics of monoclonal antibodies and Fc-fusion proteins

There are many factors that can influence the pharmacokinetics (PK) of a mAb or Fc-fusion molecule with the primary determinant being FcRn-mediated recycling. Through Fab or Fc engineering, IgG-FcRn interaction can be used to generate a variety of therapeutic antibodies with significantly enhanced half-life or ability to remove unwanted antigen from circulation. Glycosylation of a mAb or Fc-fusion protein can have a significant impact on the PK of these molecules. mAb charge can be important and variants with pI values of 1-2 unit difference are likely to impact PK with lower pI values being favorable for a longer half-life. Most mAbs display target mediated drug disposition (TMDD), which can have significant consequences on the study designs of preclinical and clinical studies. The PK of mAb can also be influenced by anti-drug antibody (ADA) response and off-target binding, which require careful consideration during the discovery stage. mAbs are primarily absorbed through the lymphatics via convection and can be conveniently administered by the subcutaneous (sc) route in large doses/volumes with co-formulation of hyaluronidase. The human PK of a mAb can be reasonably estimated using cynomolgus monkey data and allometric scaling methods.

Progress on the Study and Application of Serum Adenosine Deaminase in the Diagnosis of Autoimmune Diseases / 现代检验医学杂志

Adenosine deaminase (ADA)plays an important role in the regulation of normal immune system.The altered activ-ity of serum ADA could associate with some autoimmune diseases(AID).Various studies abroad have found the elevated ac-tivity of serum ADA compared with healthy controls in many kinds of AID such as systemic lupus erythematosus (SLE), rheumatoid arthritis(RA),et al (P<0.05).Many studies foused on the correlation of altered activity of serum ADA with the disease severity,but there is still controversy.To explore the diagnostic value of serum ADA in AID,make a review a-bout the application research progress of ADA in several AID.

Uric acid-lowering active ingredients and mechanism of Cichorium intybus / 中草药

Objective: To investigate the active ingredients of chicory on uric acid-lowering, and make a preliminary study on the safety as well as mechanism of uric acid-lowering. Methods: Fifty quails were evenly randomized into five groups, namely normal group, model group, benzbromarone (20 mg/kg) group, high-dose and low-dose mixture groups (150, and 50 mg/kg), 10 quails in each group. Except for the normal group, the quails in other groups were given high purine diet (ordinary forage mixed with 15 g/kg of yeast extract powder) to induce hyperuricemia model. And then we observed the changes of UA, ALT, AST, Cr, BUN, XOD, and ADA levels in serum during the treatment. Results: During the molding period, model group of serum UA level significantly increased (P 0.05) in 7-21 d; The XOD and ADA levels showed different degrees of inhibition. Conclusion: Chlorogenic acid, aesculin, as well as chicoric acid has the effect on lowering serum uric acid level in quail hyperuricemia model, which may be associated with reducing the activities of XOD and ADA levels.

To study the combined use of pleural fluid lymphocyte/ neutrophil ratio and ADA for the diagnosis of tuberculous pleural effusion

Background: Pulmonary tuberculosis is the most frequent cause of death by an infectious agent worldwide. Among the extra pulmonary presentations after tuberculous lymphadenitis, pleural TB is the second most frequent Failure to diagnose and treat pleural TB can result in progressive disease with the involvement of other organs in as many as 65% of patients. Conventional methods have proven to be insufficient for diagnosis of pleural TB. Hence, this study was aimed to determine whether combined use of pleural fluid lymphocyte neutrophil ratio and ADA activity would provide a more efficient means for diagnosing tuberculous pleurisy than the use of ADA levels. Aim: To determine whether the combined use of ADA activity and lymphocyte/neutrophil ratio would provide a more efficient means for diagnosing tuberculous pleural effusion than with the use of ADA alone. Materials and methods: Present study was hospital based prospective observational study carried out from February 2016 to July 2016. All the patients with pleural effusion admitted in medical ward at GRH Madurai. Information collected through preformed and pretested proforma. The qualifying patients were undergoing detail history, clinical examination and investigation. Patients were classified as exudative and transudative pleural effusion based on light’s criteria Patients with MRS score of 5 and 6 were declared as very poor outcome and MRS of 3 and 4 as poor outcome. Patients Ramasamy Suresh, Victor Theophilus Premkumar. To study the combined use of pleural fluid lymphocyte/ neutrophil ratio and ADA for the diagnosis of tuberculous pleural effusion. IAIM, 2017; 4(9): 1-5. Page 2 with MRS 0, and 1 were considered as good outcome. Statistical analysis was done by One way ANOVA, Pearson correlation and Chi square test. Results: There was significant correlation between the combined use of ADA along with L/N ratio than ADA alone for diagnosing tuberculous Pleural effusion. Conclusions: The combined use of ADA along with L/N ratio would provide a more efficient means for diagnosing tuberculous Pleural effusion than the use of ADA alone.

Tubercular Abscess: Rare Variant of CNS Tuberculosis.

Tuberculosis is a great burden on global health specially in developing country such as India.This disease has a wide spectrum of presentation most commonly pulmonary. Tuberculosis can involve almost every part of the body but the disease manifestation mainly depends upon the patient health status, bacterial virulence and lastly the environment of the patient. Along with involvement of lungs it can also involve pleura, lymph nodes, skin, uterus, follapian tubes, ovary, meninges, spine, bones, and rarely it can also involve the brain parenchyma leading to brain abscess formation. It’s a rare clinical entity only diagnosed on imaging and when diagnosed should be treated accordingly.